Description

A molar pregnancy is a rare complication of pregnancy. This implies an unusual growth of cells, called the trophoblast. These cells tend to become the organ that nourishes the growing fetus. This organ is also known as the placenta.

There are two types of molar pregnancy — complete molar pregnancy and partial molar pregnancy. In a complete molar pregnancy, the placental tissue is swollen and appears to form fluid-filled cysts. There is no fetus.

In a partial molar pregnancy, the placenta can have both regular and irregular tissue. It may be a fetus, but the fetus cannot survive. The fetus is usually lost early in the pregnancy.

A molar pregnancy can have serious complications, including a rare form of cancer. A molar pregnancy requires early treatment.

Symptoms

A molar pregnancy can seem normal pregnancy to the first. But most of molar pregnancies cause symptoms that may include:

  • Dark brown or bright red bleeding from the vagina during the first three months
  • Nausea and vomiting
  • Sometimes grapelike cysts that pass from the vagina
  • Pelvic pressure or pain

Due to the improvement of the ways to detect a molar pregnancy, the majority are in the first quarter. If you are not in the first three months, the symptoms of a molar pregnancy can include:

  • A uterus grows quickly and be too large in early pregnancy
  • Preeclampsia, a condition that causes high blood pressure and protein in the urine before 20 weeks of pregnancy
  • Ovarian cysts
  • The hyperactivity of the thyroid, also known as hyperthyroidism

Causes

A fertilized egg atypically causes a molar pregnancy. Human cells usually have 23 pairs of chromosomes. In a typical example of fertilization; a chromosome from each pair comes from the father and the other from the mother.

In a complete molar pregnancy, one or two sperm fertilize an egg. The chromosomes of the ovum of the mother are absent or do not function. The father's chromosomes are copied. There are none of the mother.

In a partial or incomplete molar pregnancy, the mother, the chromosomes are present, but the parent provides two sets of chromosomes. The embryo then has 69 chromosomes instead of 46. This most often occurs when two sperm fertilize an egg, resulting in an extra copy of the genes of the father.

Risk factors

The factors that can contribute to a molar pregnancy include:

  • Previous molar pregnancy. If you've had a molar pregnancy, you are more likely to have another. A repetition of a molar pregnancy occurs, on average, 1 out of every 100 people.
  • Age of the mother. A molar pregnancy is more likely in people over the age of 43 years, or under the age of 15 years of age.

Complications

After the removal of a molar pregnancy, the molar tissue may remain and continue to grow. This is called persistent neoplasia, gestational trophoblastic (NTG). GTN occurs more often in complete molar pregnancies in partial molar.

A sign of the persistence of the GTN is a high level of human chorionic gonadotropin (HCG) — a hormone of pregnancy — after the molar pregnancy has been deleted. In some cases, the moon that makes the molar pregnancy is deep in the middle layer of the uterine wall. This makes the bleeding of the vagina.

Persistent GTN is usually treated with chemotherapy. Another possibility of treatment is removal of the uterus, also known as the hysterectomy.

Rarely, a tumor is cancerous form of GTN known as choriocarcinoma develops and spreads to other organs. Choriocarcinoma is usually successfully treated with chemotherapy. A complete molar pregnancy is more likely to have this type of complications of a partial molar pregnancy.

Prevention

If you've had a molar pregnancy, talk with your pregnancy care provider before trying to get pregnant again. You might want to wait six months to a year. The risk of having another molar pregnancy is low, but more than once you've had a molar pregnancy.

During future pregnancies, a care provider can make at the beginning of ultrasounds to check on its status and make sure that the baby is developing.

Diagnosis

A health care provider who suspects a molar pregnancy, it is likely that you order the blood tests and an ultrasound. During the beginning of pregnancy, an ultrasound may involve wandlike device placed in the vagina.

As early as eight or nine weeks of pregnancy, an ultrasound scan of a complete molar pregnancy may show:

  • No embryo or fetus.
  • There is No amniotic fluid
  • A thick cystic placenta to almost fill the uterus
  • Ovarian cysts

An ultrasound of a partial molar pregnancy may show:

  • A fetus is smaller than expected
  • Low amniotic fluid
  • Placenta that seems unusual

After finding a molar pregnancy, a health care provider can check if there are other medical problems, including:

  • Preeclampsia
  • Hyperthyroidism
  • Anemia

Treatment

A molar pregnancy can't continue. To avoid complications, the tissue of the placenta should be removed. The treatment usually consists of one or more of the following steps:

  • Dilation and curettage (D&C).This procedure eliminates the molar tissue from the uterus. You lie on a table on your back with your legs in the stirrups. You will receive medication to numb you or put you to sleep. After opening the cervix, the doctor removes tissue in the uterus with a suction device. AD&Cfor a molar pregnancy is usually performed in a hospital or surgery center.
  • The removal of the uterus. This rarely happens, if there is an increased risk of neoplasia, gestational trophoblastic (NTG) and there is no desire for future pregnancies.
  • HCGmonitoring.After the molar tissue is removed, a provider keeps the measurement of theHCGlevel until it goes down. A high level of ofHCGin the blood may require a longer treatment.

Dilation and curettage (D&C). This procedure eliminates the molar tissue from the uterus. You lie on a table on your back with your legs in the stirrups. You will receive medication to numb you or put you to sleep.

After opening the cervix, the doctor removes tissue in the uterus with a suction device. A D&C for a molar pregnancy is usually performed in a hospital or surgery center.

HCGmonitoring. After the molar tissue is removed, a provider maintains measure the level of HCG until it goes down. A high level of HCG in the blood may require a longer treatment.

After treatment for molar pregnancy is completed, the doctor can check the HCG levels during six months, to ensure that non-woven molar is left. For people with GTN , the levels of HCG are reviewed by a year after the chemotherapy has been completed.

Due to the pregnancy, the HCG levels also increase during a normal pregnancy, a doctor might recommend waiting 6 to 12 months before trying to get pregnant again. The doctor may recommend a reliable form of birth control during this time.

Coping and support

The loss of a pregnancy can be very hard. Give yourself time to grieve. Talk about your feelings and allow yourself to fully feel. Turn to your partner, family or friends for support. If you are having problems with the management of your emotions, talk with your pregnancy care provider or a counselor.

Preparing for your appointment

It is likely to start by seeing your provider of family care or pregnancy care provider. Here's some information to help you prepare for your appointment.

What you can do

Ask a friend or family member to go with you to your appointment, if possible. To have someone that can help to remember the information that is obtained. Make a list of the following:

  • Your symptoms, including when they started and how they have changed over time.
  • The date of your last menstrual period, if you remember.
  • Key personal information, including to other medical conditions you may have.
  • All medications , vitamins or supplements that you take, including over-dose.
  • Questions to ask your provider.

For molar pregnancy, some questions are:

  • What is likely causing my symptoms?
  • What tests do I need?
  • What treatment do you recommend it?
  • I need to follow any kind of restrictions?
  • What emergency symptoms should I watch out for in the home?
  • What are my chances of giving birth in the future?
  • How long should I wait before trying to get pregnant again?
  • Does my condition increasing my risk of developing cancer in the future?
  • Do you have brochures or printed material I can have? What sites do you recommend?

Don't hesitate to ask other questions you have.

What to expect from your doctor

Your health care provider may ask you questions, such as:

  • The symptoms been permanent or casual?
  • Do you have pain?
  • In comparison with their heaviest days of menstrual flow, it is bleeding more, less, or the same? Have passed grapelike cysts of your vagina?
  • It has been lightheaded or dizzy?
  • Has had a past in the molar pregnancy?
  • Do you want to become pregnant in the future?
Symptoms and treatment of Molar pregnancy