The genetic origins of the different types of molar pregnancies are demonstrated in Fig. 15.1. PMs are triploid with two sets of paternal and one set of maternal chromosomes. Macroscopically PM often resembles the normal products of conception with an embryo initially present which usually dies by week 8-9. The histology shows less swelling of the chorionic villi than in complete mole and there are usually only focal changes. As a result the diagnosis of PM can often be missed after a miscarriage or termination.
The clinical presentation of PM is most frequently via irregular bleeding or by detection on routine ultrasound. The obstetric management is by suction evacuation and these patients should all be followed up by serial hCG measurement.
Fortunately PM rarely moves onto malignant disease with generally only one or two cases of malignant disease seen per year at CXH with an overall risk of 0.5% requiring chemotherapy after a PM .
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