Cystic proliferation of Chorionic epithelium is known as?

NCL (MP) Nursing Officer - 2020

Obstetrics & Gynecology

Easy

Appeared in: NCL (MP) Nursing Officer - 2020

Explanation

Hydatidiform mole is a form of gestational trophoblastic disease (GTD) resulting from abnormal fertilization.
It is defined by the cystic (hydropic or grape-like) swelling of chorionic villi and the excessive proliferation of the chorionic epithelium (trophoblastic cells).
The image provided shows the classic macroscopic appearance of a hydatidiform mole, which resembles a bunch of grapes.
Clinically, it often presents with vaginal bleeding, a uterus that is larger than expected for the gestational age, and markedly elevated serum levels of human chorionic gonadotropin (β-hCG).
Ultrasound imaging typically reveals a characteristic "snowstorm" pattern with no identifiable fetus in a complete mole.

Option B: Oedematous placenta involves generalized swelling and fluid accumulation in the placental tissue but lacks the specific cystic proliferation of the trophoblast that defines a hydatidiform mole.
Option C: Ectopic pregnancy refers to the implantation of a pregnancy outside the uterine cavity, most commonly in the fallopian tube. It is a locational abnormality, not a proliferative disorder of the placenta.
Option D: Polyhydramnios is the excessive accumulation of amniotic fluid. It is a condition related to the volume of fluid in the amniotic sac, not a tumor or proliferation of the placental tissue itself.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Gestational Trophoblastic Disease as background academic context rather than a clinical decision trigger.
The primary treatment for a hydatidiform mole is suction curettage to evacuate the uterine contents.
Post-evacuation follow-up is critical. Serial β-hCG levels must be monitored to ensure they return to normal. Persistently elevated or rising levels may indicate persistent gestational trophoblastic neoplasia (GTN), such as an invasive mole or choriocarcinoma, requiring chemotherapy.
Patients must use reliable contraception (commonly oral contraceptives) for 6-12 months during the follow-up period to avoid a new pregnancy, as rising β-hCG from a new gestation would be indistinguishable from that of persistent molar disease.

How to Approach the Question

First, analyze the question stem for keywords. The key terms are "cystic proliferation" and "Chorionic epithelium."
Next, examine the provided image. The image shows a mass of grape-like vesicles, which is the classic macroscopic appearance of a specific condition.
Correlate the keywords with the visual evidence. "Cystic proliferation" directly describes the formation of these vesicles. "Chorionic epithelium" points to a disorder of the placenta's outer layer (the trophoblast).
Evaluate the options based on this understanding. Hydatidiform mole is defined by these exact features.
Eliminate the other options by recalling their definitions: Oedematous placenta is simple swelling, ectopic pregnancy is implantation in the wrong location, and polyhydramnios is excess amniotic fluid. None of these involve cystic proliferation of the chorion.
Confirm the choice by recalling that hydatidiform mole is a tumor of the placenta characterized by swollen, cystic villi.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1033-1035

E6 Gynecology Williams p. 360-428