Red flag to remember
Report early-onset severe hypertension, headache, or visual changes (preeclampsia before 20 weeks).
What is hydatidiform mole?
A complete mole has no fetal tissue (paternal chromosomes only), while a partial mole has some fetal/abnormal triploid tissue. Classic picture: grape-like vesicles, very high hCG, and uterus larger than dates.
Key points to remember
- hCG levels are markedly elevated and rise abnormally rather than following a normal pregnancy curve.
- Uterus is often larger than expected for gestational age and contains no fetal heart tones with a complete mole.
- Painless dark-brown to bright-red vaginal bleeding, often with passage of grape-like vesicles, is characteristic.
- Higher risk of early severe preeclampsia (before 20 weeks), hyperemesis gravidarum, and hyperthyroidism due to high hCG.
- Treatment is suction curettage (D&C) to evacuate the uterus; tissue is sent for pathology to rule out choriocarcinoma.
- Choriocarcinoma is a malignant complication, so serial hCG monitoring after evacuation is essential.
Signs & symptoms
- Dark brown/red vaginal bleeding
- Uterus larger than dates
- Severe N/V, early preeclampsia
Nursing priorities
- Monitor and report vaginal bleeding amount, and save passed tissue for examination.
- Assess for signs of preeclampsia (BP, headache, visual changes) and hyperthyroidism even early in pregnancy.
- Prepare the client for suction evacuation/D&C and provide emotional support for pregnancy loss.
- Reinforce strict follow-up with serial hCG levels and reliable contraception during monitoring.
- Administer Rho(D) immune globulin if the client is Rh-negative.
Labs & values
hCG: markedly elevated, often >100,000 mIU/mL (normal nonpregnant <5 mIU/mL)
Hgb12-16 g/dL (assess for anemia from bleeding)
Patient teaching
- Avoid pregnancy for 6-12 months so hCG can be tracked to detect cancer; use reliable contraception.
- Keep all serial hCG follow-up appointments even when feeling well.
- Report any new bleeding, persistent nausea, or respiratory symptoms promptly.
Red flags: report now
- Report early-onset severe hypertension, headache, or visual changes (preeclampsia before 20 weeks).
- Report heavy bleeding, passage of vesicles, or signs of hypovolemic shock.
- Rising or plateauing hCG after evacuation suggests persistent disease/choriocarcinoma and must be reported.
References
Clinical references for this topic
Study Hydatidiform Mole in the app4,000+ NCLEX questions with a rationale on every answer, NGN case studies and timed mock exams.See how CinnaRN works
Start free Want more Physiological Adaptation questions?We'll email you a free set on Hydatidiform Mole. No account needed.
Was this helpful?