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Ectopic pregnancy involves implantation of the embryo outside the uterine cavity, most commonly in the fallopian tube. It presents with abdominal pain and vaginal bleeding, but does not produce grape-like vesicles. Ultrasound typically shows an empty uterus with adnexal mass. hCG levels rise abnormally slowly. There is no trophoblastic overgrowth or vesicular tissue passage.

Threatened miscarriage refers to vaginal bleeding in early pregnancy with a closed cervical os and viable intrauterine pregnancy. It does not involve abnormal placental growth or vesicle passage. The uterus is appropriate for gestational age, and hCG levels are consistent with normal pregnancy. No hydropic villi or trophoblastic proliferation is present.

Cervical friability is a physical finding where the cervix bleeds easily on contact, often due to infection, inflammation, or hormonal changes. It is unrelated to pregnancy loss or placental pathology. It does not involve trophoblastic tissue or vesicle formation. No abnormal hCG levels or uterine enlargement are seen.

Light spotting with mild cramping is more consistent with early pregnancy changes or a threatened miscarriage. Molar pregnancy typically presents with heavy bleeding and uterine enlargement, not mild symptoms. The spotting lacks the diagnostic specificity of vesicle passage and does not reflect trophoblastic overgrowth.

Unilateral pelvic pain is a hallmark of ectopic pregnancy, especially when associated with tubal rupture. Molar pregnancy does not cause localized pain but rather diffuse uterine symptoms. There is no implantation outside the uterus, and no adnexal tenderness or mass is expected.

Loss of pregnancy symptoms may occur in missed miscarriage but is not characteristic of molar pregnancy. In fact, molar pregnancy often exaggerates symptoms due to excess hCG, leading to severe nausea, breast tenderness, and early-onset preeclampsia. Symptom loss contradicts the hyperactive hormonal profile of molar gestation.

Laparoscopy is not indicated for molar pregnancy. It is used for ectopic pregnancy, pelvic masses, or diagnostic exploration. Molar pregnancy is intrauterine and best managed by uterine evacuation. Laparoscopy does not provide adequate access to the uterine cavity for removing trophoblastic tissue.

Hysterectomy is reserved for select cases such as women who have completed childbearing and have invasive mole or uncontrolled bleeding. It is not the first-line treatment. D&C remains the standard unless there are complications or recurrence. Hysterectomy also precludes future fertility, making it inappropriate for most patients.

Myomectomy is a procedure for removing uterine fibroids, not molar tissue. It targets smooth muscle tumors and has no role in managing gestational trophoblastic disease. Molar pregnancy involves placental tissue, not myometrial pathology, and requires complete evacuation of chorionic villi.