Molar Pregnancy

Having a successful pregnancy without complications is what most couples wish for. However, there are times when pregnancy does not proceed the way it should. If it is a molar pregnancy, it can turn out to be a real problem. This condition is rare and complicated and it is an irregularity of the placenta caused by a problem when the egg and sperm unite at fertilisation. In Australia, about 1 on every 1400 women with early pregnancy symptoms has a molar pregnancy. Women at their 40s and above are high risk for a molar pregnancy.

What Is Molar Pregnancy?

A molar pregnancy is the result of a genetic error during fertilisation process which leads to growth of abnormal tissue within the uterus. It happens when the tissue that usually becomes a foetus instead becomes a growth, called a mole, in the uterus. Even though it is not an embryo, the mole triggers the symptoms of pregnancy; as a result, it mimics pregnancy even though you’re not actually pregnant. The growth of this material is rapid compared to normal foetal growth.

Molar pregnancy is also referred as hydatidiform mole (or hydatid mole, mola hydatidosa). The word “hydatidiform” derives from “hydatid”, which means ‘water-filled cysts’. Other terms used for molar pregnancy are vesicular mole or trophoblastic disease. H-mole is a pregnancy where the placenta contains grapelike vesicles that are commonly visible with the eye. The vesicles grow by distension of the chorionic villi by fluid. When examined in a microscope, hyperplasia of the trophoblastic tissue is noted. If left untreated, an H-mole will most likely to result a spontaneous abortion.
There are two types of molar pregnancies, partial and complete.

What Is A Partial Molar Pregnancy?

In partial molar pregnancy, an egg is fertilised by two sperm. Normally when this happens, it results twin pregnancy. However, in partial molar pregnancy, the placenta grows into a mole instead. Any foetal tissue that forms is likely to have severe defects. This occurs when the mass contain both the abnormal cells and an embryo that has severe defects. In this condition, the foetus will be overwhelmed by the growing abnormal mass rather quickly.

What Is A Complete Molar Pregnancy?

In complete molar pregnancy, an egg with no genetic information is fertilised by a sperm. The sperm grows on its own because the egg is empty, but it only results to a lump of tissue. It cannot become an embryo. As the tissue grows, it looks a bit like a grape-like cluster. This cluster is called a mole, and it can fill the uterus. Complete molar pregnancy has only placental parts. The placenta grows and produces the pregnancy hormone, human chorionic gonadotropin (hCG). When an ultrasound is used, it will show that there is no foetus, only a placenta.

What Are The Signs And Symptoms Of Molar Pregnancy?

  • Severe nausea and vomiting, mostly requires treatment in the hospital
  • Uterus that grows in a rapid phase compared to normal during pregnancy
  • An examination of the ovaries will show an excessive amount of hCG
  • High blood pressure that usually starts for the first time in first trimester during pregnancy. This may mean that preeclampsia is possible to happen
  • Heartbeat and foetal movement is absent
  • Vaginal bleeding during pregnancy or shortly after a pregnancy, miscarriage, or abortion
  • Few women develop hyperthyroidism. Symptoms of abnormally high levels of thyroid hormone
  • Symptoms of the tumour or cancer spreading to other organs. For example, coughing up blood may occur if the tumour goes to the lungs or abdominal pain if the tumour goes to the liver

Diagnosis And Treatment

A pelvic examination may be performed and it may show signs similar to a normal pregnancy. However, the size of the womb may be abnormal and the baby’s heart sound is absent. A blood test is also done to measure level of hCG, or the “hormone of pregnancy”. In a normal pregnancy, the level of hCG is high because of the abnormal foetal tissue. In addition, a chest x-ray or MRI or CT scan of different areas of the body may be performed of your physician suspects that the tumour has spread to other parts of the body.

  1. If diagnosed with molar pregnancy, a vacuum aspiration under general anaesthesia is used. Pelvic ultrasound may be used during the procedure to guide a complete removal of the abnormal tissue. Oxytocin is used during or after the procedure for uterine contraction. Contraction of the uterus help the uterus shrink to its pre-pregnancy form and help prevent bleeding in the uterus after the mole is removed.
  2. Hysterectomy is also an option if you have no future plans to become pregnant. This procedure reduces the chance of having gestational trophoblastic disease after a molar pregnancy.
  3. Methotrexate may be used if you are considered high risk for cancer after a molar pregnancy.

Follow Up Care
After a molar pregnancy, it is important to see your health care provider for a routine check up to watch for any cancer growth.

  • Test hCG level every 1 to 2 weeks until it is within normal limits, then measuring it every 1 to 2 months for 6 months to a year. This is performed because high levels of hCg may be a sign of cancer.
  • Avoid pregnancy while hCG levels are being examined, which mean, avoid pregnancy for about 6 months to a year. It is very important to use birth contraception during the entire period follow-up.
  • Close medical supervision is needed if you happen to conceive within 12 months of molar pregnancy treatment.

Prevention Of Molar Pregnancy

A nutritional deficiency certainly in protein deficits is found to be one of the many causes for molar pregnancy leaving apart the ovulation defects. According to research, a diet compose of animal protein and vitamin A by eating green leafy vegetables and yellow colour vegetables and fruits can help lessen the occurrence of molar pregnancies.

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