A late complication of molar pregnancy is?

Appeared in: Daman & Diu Staff Nurse - 2018

Explanation

Choriocarcinoma is a malignant, cancerous transformation of trophoblastic tissue that can occur as a sequela to a molar pregnancy.
It is classified as a late complication because it typically develops weeks to months after the initial evacuation of the hydatidiform mole.
The development of choriocarcinoma is monitored by tracking serum β-hCG levels post-evacuation; persistently high or rising levels are indicative of malignant change.
Approximately 15-20% of complete moles and 1-5% of partial moles can progress to gestational trophoblastic neoplasia (GTN), which includes choriocarcinoma.

Option A: Coagulation failure, or Disseminated Intravascular Coagulation (DIC), is an immediate or early complication of molar pregnancy.
Option B: Uterine perforation is an immediate complication, not a late one.
Option C: Shock is an immediate complication of molar pregnancy.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Molar Pregnancy as background academic context rather than a clinical decision trigger.
The nurse's primary role is patient education regarding the critical need for long-term follow-up after a molar pregnancy to detect malignancy early.
Nurses must emphasize the importance of consistent serum β-hCG level monitoring and the necessity of using reliable contraception for 6-12 months to prevent a new pregnancy, which would obscure the interpretation of hCG levels.
What if? If a patient becomes pregnant during the follow-up period, it becomes impossible to differentiate whether rising β-hCG levels are from the new pregnancy or from developing choriocarcinoma, potentially delaying a cancer diagnosis.

How to Approach the Question

First, identify the key terms in the question: 'late complication' and 'molar pregnancy'.
Analyze the options by categorizing them based on their typical onset: immediate/acute versus delayed/long-term.
Recall that shock, uterine perforation, and coagulation failure are acute events related to hemorrhage or surgical procedures, making them early complications.
Recognize that choriocarcinoma is a malignant transformation, a process that takes time to develop after the initial event.
Conclude that a cancerous sequela like choriocarcinoma fits the definition of a 'late' complication, whereas the other options are immediate crises.

Concept Tested & Keywords

QC47JEzptfCfF8lb6aMy26

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 15-23

E6 Gynecology Williams p. 366-432

E6 Obstetrics Williams p. 32-52

Practise the full Daman & Diu Staff Nurse - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.