A common manifestation of hydatidiform mole prior to 24 weeks is which of the following?

• A. Vaginal bleeding
• B. Hypertension
• C. Oligohydramnios
• D. Decreased hCG

Answer: (A)

Vaginal bleeding is the most common early sign of a hydatidiform mole. The abnormal trophoblastic tissue disrupts normal placental vessels, leading to resulting bleeding that often presents in the first half of pregnancy, sometimes with passage of vesicular tissue. Although high hCG from molar tissue can cause other effects like nausea or, less commonly, early preeclampsia, these are not as typical as the bleeding symptom before 24 weeks.

Hypertension can occur with molar pregnancy but tends to be part of an early preeclampsia picture rather than the most common presenting symptom at this stage. Oligohydramnios is not a hallmark presentation in early molar pregnancy, and decreased hCG contradicts the hallmark finding of markedly elevated hCG levels in hydatidiform mole.