Which of the following is a characteristic pathological feature of molar pregnancy?

NORCET 10 Mains

Obstetrics & Gynaecology

Easy

Appeared in: NORCET 10 Mains

Explanation

Molar pregnancy, or hydatidiform mole, is a type of gestational trophoblastic disease affecting the placenta.
Its hallmark pathological feature is the abnormal development and cystic (hydropic) degeneration of the chorionic villi.
These villi swell with fluid, lose their blood supply (become avascular), and form characteristic grape-like clusters.
This process is accompanied by the excessive proliferation of trophoblastic tissue, the cells that produce hCG.

Option B: The endometrium does not atrophy. The uterus is typically larger than expected for gestational age due to the rapidly growing molar tissue and retained blood.
Option C: Enlargement of the myometrium (uterine muscle) is a secondary effect caused by the stretching from the growing molar mass within the uterine cavity. It is not the primary disease process.
Option D: This term describes a functional failure of a placenta to support a fetus. In a complete mole, there is no fetus, and the fundamental problem is the abnormal structure of the placental tissue itself, not just its function.

Visual 1: Gross specimen image - Displaying the characteristic 'bunch of grapes' appearance of the evacuated molar tissue, which clearly shows the hydropic villi.
Visual 2: Ultrasound image - Showing the classic 'snowstorm' appearance of a complete mole, where the uterine cavity is filled with a complex, echogenic mass with multiple small cystic spaces and no fetus.
Visual 3: Microscopic image - A histological slide showing markedly swollen, avascular chorionic villi and circumferential proliferation of trophoblastic cells, confirming the diagnosis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of Molar Pregnancy as background academic context rather than a clinical decision trigger.
Early diagnosis and evacuation of a molar pregnancy are critical to prevent complications like hemorrhage and the potential progression to a malignant form called gestational trophoblastic neoplasia (GTN).
Nurses play a key role in monitoring serum hCG levels post-evacuation. A plateau or rise in hCG indicates persistent disease requiring further evaluation and often chemotherapy.
Patient education on the need for reliable contraception for at least 6 months after evacuation is crucial to prevent a new pregnancy from confusing hCG monitoring.

How to Approach the Question

First, identify the core concept of the question: the 'characteristic pathological feature' of a molar pregnancy.
Recall the definition of a molar pregnancy (hydatidiform mole). It is fundamentally a disease of the placenta, specifically the chorionic villi.
Evaluate each option against this core definition. Option A, 'Degeneration of chorionic villi,' directly describes the primary problem in the placental tissue.
Analyze the other options. 'Atrophy of endometrium' is the opposite of what happens. 'Hypertrophy of myometrium' is a secondary effect of uterine stretching, not the primary disease.
'Placental insufficiency' is a term for a functional problem, whereas molar pregnancy is a structural abnormality of the tissue itself.
Therefore, the most accurate and primary pathological feature is the degeneration of the chorionic villi.

Concept Tested & Keywords

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