What is the mainstay initial management for molar pregnancy?

What is the mainstay initial management for molar pregnancy?

• A. Hysterectomy
• B. Observation
• C. Suction curettage
• D. Expectant management

Answer: (C)

Suction curettage to evacuate the uterus of molar tissue is the initial management. Removing the abnormal trophoblastic tissue promptly controls bleeding, reduces the risk of persistent gestational trophoblastic disease, and allows histologic confirmation of the diagnosis. This approach is preferred because leaving the mole in place can lead to ongoing growth and potential malignant transformation, whereas observation or expectant management is unsafe. Hysterectomy is not the first-line choice for most reproductive-age patients who wish to preserve fertility, though it may be considered later in select cases or if childbearing is complete. After evacuation, serial beta-hCG monitoring is essential to ensure the disease resolves, and contraception should be used during surveillance. If hCG does not fall appropriately, further evaluation for persistent GTD and possible chemotherapy (such as methotrexate) may be needed.

Suction curettage to evacuate the uterus of molar tissue is the initial management. Removing the abnormal trophoblastic tissue promptly controls bleeding, reduces the risk of persistent gestational trophoblastic disease, and allows histologic confirmation of the diagnosis. This approach is preferred because leaving the mole in place can lead to ongoing growth and potential malignant transformation, whereas observation or expectant management is unsafe. Hysterectomy is not the first-line choice for most reproductive-age patients who wish to preserve fertility, though it may be considered later in select cases or if childbearing is complete. After evacuation, serial beta-hCG monitoring is essential to ensure the disease resolves, and contraception should be used during surveillance. If hCG does not fall appropriately, further evaluation for persistent GTD and possible chemotherapy (such as methotrexate) may be needed.