For the practicing obstetrician and gynecologist, the array of nonneoplastic conditions associated with molar pregnancy requires a compulsive, searching clinical attitude that demands an understanding of a number of disorders in organ systems which are not in the routine purview of the specialty. Thus, the identification of high-risk patients combined with the multidisciplinary approach to patient care is essential for the proper management of these conditions. Since the primary clincal error is lack of recognition of such a patient, the consistent, competent physician must be organ-system-oriented rather than procedure-focused. The patient at risk for nonneoplastic complications of molar pregnancy is often easily identified with a computer physical examination and appropriate laboratory assessment if special attention is given to the cardiovascular and respiratory systems. While the precise cause of such alterations is unknown, these complications are related to an exaggerated physiologic response to high levels on human chorionic gonadotropin (hCG). These complications will be discussed in this chapter by organ system: endocrinologic, hematologic, cardiovascular, and respiratory. At the end of this chapter a case history is included to underscore the clinical factors seen in the patient at risk for nonneoplastic complications of molar gestation.
ASJC Scopus subject areas
- Obstetrics and Gynecology