A 40 years old P4+2 female has been diagnosed to have H.mole. The treatment would be :

Ans. Is c i.e. Total hysterectomy "If no fuher pregnancies are desired, hysterectomy may be preferred to suction curettage. It is a logical procedure in women aged 40 or older because atleast a third of these women will go on to develop gestational trophoblastic neoplasia." Management options for H.mole : Suction evacuation/curettage Treatment of choice. irrespective of the size of uterus Hysterectomy Treatment of choice if female has completed her family and in women 35 years as chances of developing malignant sequelae are more. Hysterotomy It is reserved only in case of H.mole complicated by hemorrhage Note: Medical induction of labour with prostaglandins. oxytocin or hypeonic saline are no longer acceptable methods for evacuation of a molar pregnancy. In the question patient is of 40 years and has completed her family so hysterectomy is the TOC. Remember : Hysterectomy only decreases the chances of malignancy in cases of hydatidiform mole and does not eliminate the necessity of follow up.