Increased B-HCG

Complete Mole

• Presentation:
  • complete chromosomes, complete mole = no fetal parts Caused by sperm fertilizing an empty egg
• US:
  • snowstorm appearance
    
• tx: Suction curettage reveals grape like mass:
• Post treatment protocol :
  • 1. Track HCG weekly
    
  • 2. Place patient on OCPs
    
  • 3. If they get pregnant can’t tell invasive mole vs regular pregnancy

Snow Storm Appearance Mikael Häggström. / CC0

Incomplete Mole

• Presentation:
  • has some fetal parts. When 2 sperm fertilize 1 egg. forms 69 chromosomes
• US:
  • snowstorm appearance
    
• tx: Suction curettage reveals grape like mass
• Post treatment protocol :
  • 1. Track HCG weekly
    
  • 2. Place patient on OCPs
    
  • 3. If they get pregnant can’t tell invasive mole vs regular pregnancy

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Snow Storm Appearance Mikael Häggström. / CC0

Hyperthyroidism

• Presentation:
  • B-HCG can mimic TSH thus it can cause hyperthyroidism.
    
  • BHCG also can cause morning sickness and hyperemesis gravidarum

Choriocarcinoma

• Treatment:
  • MAC
    
  • Methotrexate
    
  • Actinomycin D
    
  • Cyclophosphamide

Reference

• Molar Pregnancy Transvaginal US. Häggström, Mikael (2014). "Medical gallery of Mikael Häggström 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.008. ISSN 2002-4436. Public Domain.orBy Mikael Häggström, used with permission.