Clinical intervention for hydatidiform mole is which of the following?

• A. Surgical removal or dilation and curettage
• B. Observation only
• C. Antibiotics
• D. Chemotherapy

Answer: (A)

The key step in managing a hydatidiform mole is removing the molar tissue with suction dilation and curettage to evacuate the uterus and stop the overproduction of hCG. This approach directly addresses the abnormal trophoblastic tissue responsible for the mole, reducing bleeding risk, preventing uterine enlargement complications, and lowering the chance of persistent gestational trophoblastic disease.

Observation alone would let the molar tissue persist and continue producing hCG, which can lead to continued symptoms and potential progression to persistent GTD or even metastasis. Antibiotics don’t treat the underlying trophoblastic proliferation. Chemotherapy is reserved for persistent or metastatic GTD after evacuation or when invasion/metastasis is already established, not as first-line treatment for an uncomplicated mole.

After evacuation, ongoing follow-up with serial hCG measurements is essential to confirm resolution and to detect any persistent GTD, with contraception advised during the monitoring period.