Commonest complication of hydatidiform mole is:

AIIMS Raipur NO- 2019 (shift 3rd)

Obstetrics & Gynaecology

Easy

Appeared in: AIIMS Raipur NO- 2019 (shift 3rd)

Explanation

Hemorrhage is the most frequent and immediate complication of a hydatidiform mole.
The molar vesicles are highly vascular, and their separation from the uterine wall during spontaneous or surgical evacuation can cause profuse bleeding.
The uterus is often larger than expected for the gestational age and may fail to contract effectively (uterine atony) after evacuation, further contributing to blood loss.
Bleeding can be concealed or revealed and may quickly lead to hypovolemic shock if not managed promptly.

Option A: Development of carcinoma (choriocarcinoma) is a serious but late complication, not the most common one. It is considered a malignant sequela of a molar pregnancy.
Option B: Sepsis is a possible immediate complication, often resulting from incomplete evacuation or infection introduced during the procedure. However, it is significantly less common than hemorrhage.
Option C: Incomplete evacuation is a complication of the treatment (suction curettage) for a hydatidiform mole, not a direct complication of the mole itself. It is a cause of other complications like hemorrhage and sepsis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Hydatidiform Mole as background academic context rather than a clinical decision trigger.
Nurses must prioritize monitoring for signs of hemorrhage in patients with a hydatidiform mole, including tachycardia, hypotension, pallor, and assessing the amount of vaginal bleeding.
It is crucial to have intravenous access established and cross-matched blood available, especially during the evacuation procedure, as stated in SRC_3690.
Patient education on the critical need for long-term follow-up with serial serum beta-hCG levels is a key nursing responsibility to ensure early detection of persistent gestational trophoblastic neoplasia (GTN), such as choriocarcinoma.

How to Approach the Question

First, identify the core subject of the question: 'hydatidiform mole'.
Next, focus on the keyword in the question stem: 'Commonest'. This asks for the most frequent complication.
Analyze the options by categorizing them. Differentiate between immediate complications of the disease process (hemorrhage, sepsis) and late complications or sequelae (carcinoma).
Recognize that 'incomplete evacuation' is a complication of the treatment procedure, not the disease itself.
Recall or deduce that the abnormal, highly vascular nature of the molar tissue makes hemorrhage the most likely and frequent immediate problem.
Select the option that represents the most common, direct complication of the condition.

Concept Tested & Keywords

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

E6 Obstetrics Williams p. 35-55