Molar Pregnancy
Protocols
Clinical Features:
- Short peroid of amenorrhea
- H/O of vaginal bleeding
- H/O per vaginal grape like vesicle expulsion
- Lower abdominal pain
- Hyperemesis Gravidarum
On examinatoin:
- patients may shock
- anaemia : +++/++
- edema: +/++
- Fetal sound abscent
Investigations:
- CBC
- Beta HCG : > 2 fold rises
- Usg of P/P
- Blood grouping & rh typing
- serum creatinine
- X-ray chest to see lungs metastesis
Rx: (indoor)
- Diet: NPO
- Complete bed rest
- 02 inhalation stat & sos
- contineous catheterization
- Blood transfusion : if needed
- Monitor vital signs
1. Inf. Hartsol (2L)
- 30 drop/min
2. Inj.Oricef (ceftriaxone) (1gm)
- 1 vial I/V ....stat & BD
3. Inj. Viset (Tiemonium)(5mg)
- 2 vial I/V stat & TDS
4. Inj.Esonix (esomeprazole) (40mg)
- 1 vial I/V stat& BD
5. Inj.Xamic (Tranexamic acid)(500mg)
- 1 ample I/V stat & TDS
6. Suction evacuation
if Cervix unfavourable :
tab. cytomis (misoprostol)(200mg)
- 3 tablet per vagina (posterior fornix) before 3 hours of OT
Post Operative order:
Same as indoor
Fresh order/Discharge:
1. Tab.Ciprocin (ciprofloxacin)(500mg)/Cef-3(cefixime)(200mg)
- 1+0+1................7 days
2. Filmet (metronidazole) (400mg)
- 1+1+1...........5 days
3. Cap.Esonix (esomeprazol)(20mg)
- 1+0+1..............10 days
4. Tab. Rivotril (clonazepam)(0.5mg)
- 0+0+1..................10 days
Advice:
- Takes medicine regularly
- Follow up after 1 weeks with Beta HCG ,X-ray chest repeat
- Pt needs follow up up to 1 year