Methotrexate is recommended as part of the treatment plan for which obstetric complication?
A.
Missed abortion
B.
Abruptio placentae
C.
Unruptured ectopic pregnancy
D.
Complete hydatidiform mole
The Correct Answer and Explanation is:
The correct answer is D. Complete hydatidiform mole.
Explanation:
Methotrexate is a medication that is often used in the treatment of various types of obstetric complications, including those involving abnormal tissue growth. In the context of obstetric complications, methotrexate is particularly relevant in the management of a complete hydatidiform mole, also known as a molar pregnancy.
Complete Hydatidiform Mole: A complete hydatidiform mole is a type of gestational trophoblastic disease (GTD) where the placenta forms abnormally, resulting in the development of numerous cysts and an absence of a viable fetus. This condition is characterized by the proliferation of abnormal trophoblastic tissue. It arises when an egg with no genetic material is fertilized by a sperm that then duplicates its own chromosomes, resulting in a 46,XX karyotype of paternal origin.
Role of Methotrexate: Methotrexate is a folic acid antagonist that inhibits DNA synthesis, thereby preventing the proliferation of rapidly dividing cells, such as those found in the abnormal trophoblastic tissue of a hydatidiform mole. This medication is effective in treating persistent or invasive molar pregnancies, particularly when the disease is resistant to surgical treatment alone or when there is evidence of residual trophoblastic tissue.
Other Options:
- A. Missed Abortion: A missed abortion involves the retention of a non-viable fetus in the uterus, which is generally managed through surgical dilation and curettage (D&C) rather than methotrexate.
- B. Abruptio Placentae: Abruptio placentae, or placental abruption, is a condition where the placenta prematurely detaches from the uterine wall. This situation is often managed through delivery and supportive care rather than the use of methotrexate.
- C. Unruptured Ectopic Pregnancy: An unruptured ectopic pregnancy, where the embryo implants outside the uterus, can be treated with methotrexate to dissolve the ectopic tissue. However, this is specific to ectopic pregnancies and not a complete hydatidiform mole.
Thus, methotrexate is specifically indicated in the treatment of complete hydatidiform mole due to its role in managing abnormal trophoblastic tissue proliferation.