Pregnancy-Related Neoplasm

PREGNANCY-RELATED NEOPLASM

Hydatidiform mole is a type of gestational trophoblastic neo-plasm that occurs in 1 in 1,000 pregnancies. Delayed menses with spotting is the most common sign. Hyperemesis and uterine en-largement beyond that expected for gestational dates are also indicative. Moles can be partial or complete. Complete moles are more likely to be associated with medical complications. Pregnancy-induced hypertension (formerly called preeclampsia), pregnancy-related complex of symptoms that may include edema, hypertension, and proteinuria, may occur. Treatment con-sists of suction curettage followed by monitoring serial beta-human chorionic gonadotropin (HCG) levels, which usually take about 2.5 months to return to normal. This condition may recur. Moles can be invasive also.

Choriocarcinoma, another gestational neoplasm that usuallyoccurs in the postpartum period, is a placental site trophoblastic tumor. These malignancies are being diagnosed more readily and treated more effectively today due to the availability of testing for HCG, a sensitive marker that can be used for monitoring. Ultra-sound is also used for making the diagnosis. These malignancies are usually found in obstetric patients and are described in detail in obstetric and oncologic textbooks. Nurses need to be aware that these conditions are traumatic, anxiety-producing, and often very stressful for the patient since they are often associated with pregnancy loss.