What is the role of surgery in the management of hydatidiform mole?

Updated: Feb 16, 2018
  • Author: Lisa E Moore, MD, FACOG; Chief Editor: Warner K Huh, MD  more...
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Answer

Evacuation of the uterus by dilation and curettage is always necessary.

Prostaglandin or oxytocin induction is not recommended because of the increased risk of bleeding and malignant sequelae.

Intravenous oxytocin should be started after dilation of the cervix at the initiation of suctioning and continued postoperatively to reduce the likelihood of hemorrhage. Consideration of using other uterotonic formulations (eg, Methergine, Hemabate) is also warranted.

Respiratory distress can occur at the time of surgery. This may be due to trophoblastic embolization, high-output congestive heart failure caused by anemia, or iatrogenic fluid overload. Distress should be aggressively treated with assisted ventilation and monitoring, as required. [27]


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