What is a molar pregnancy?
A positive pregnancy test is often followed by the joy of a newborn baby 9 months later. But there are times when pregnancy ends in a loss. A molar pregnancy is one of those. During a healthy pregnancy, the placenta grows inside your uterus. It nourishes your baby through the umbilical cord. A molar pregnancy is the result of a genetic error during the fertilization process that leads to a growth of abnormal tissue or tumor within the uterus. Molar pregnancies rarely involve a developing embryo, and the growth of this material is rapid compared to normal fetal growth. It has the appearance of a large and random collection of grape-like cell clusters.
Types of molar pregnancy
- Partial molar pregnancy: In a partial molar pregnancy, there may be normal placental tissue along with abnormally forming placental tissue. There may also be formation of a fetus, but the fetus is not able to survive, and is usually miscarried early in the pregnancy. This condition happens when the embryo has two sets of chromosomes from the father and one from the mother, so it has 69 chromosomes instead of 46. This can happen when the father’s chromosomes are copied or when two sperm fertilize one egg.
- Complete molar pregnancy: In a complete molar pregnancy, the placental tissue is abnormal but there’s no formation of fetal tissue. It happens when chromosomes from the mother’s egg are lost or not working, and chromosomes from the father are copied, so all 46 chromosomes come from the father.
Symptoms of molar pregnancy
A molar pregnancy may seem like a normal pregnancy at first, but most molar pregnancies cause specific signs and symptoms, including:
- Dark brown to bright red vaginal bleeding during the first trimester
- Severe nausea and vomiting
- Sometimes vaginal passage of grapelike cysts
- Pelvic pressure or pain
If you experience any signs or symptoms of a molar pregnancy, consult your doctor. He or she may detect other signs of a molar pregnancy, such as:
- Rapid uterine growth — the uterus is too large for the stage of pregnancy
- High blood pressure
- Preeclampsia — a condition that causes high blood pressure and protein in the urine after 20 weeks of pregnancy
- Ovarian cysts
- Overactive thyroid (hyperthyroidism)
Approximately 1 in every 1,000 pregnancies is diagnosed as a molar pregnancy. Various factors are associated with molar pregnancy, including:
- Maternal age. A molar pregnancy is more likely in women older than age 35 or younger than age 20.
- Previous molar pregnancy. If you’ve had one molar pregnancy, you’re more likely to have another. A repeat molar pregnancy happens, on average, in 1 out of every 100 women.
A molar pregnancy can’t continue as a normal viable pregnancy. To prevent complications, the abnormal placental tissue must be removed. Most molar pregnancies will spontaneously. Otherwise, the following methods are done to end it:
- Dilation and curettage (D&C): Doctor will remove the molar tissue from your uterus with a procedure called dilation and curettage (D&C). A D&C is usually done as an outpatient procedure in a hospital. During the procedure, the patient will receive a local or general anesthetic. During this procedure, your doctor opens your cervix with special tools and removes the tissue from your uterus with a vacuum device. This is the best option for you if you want to get pregnant again. He or she will then dilate your cervix and
- Hysterectomy: Rarely, if there is increased risk of gestational trophoblastic neoplasia (GTN) and there’s no desire for future pregnancies, the uterus may be removed (hysterectomy).
- HCG monitoring: After the molar tissue is removed, your doctor will repeat measurements of your HCG level until it returns to normal. If you continue to have HCG in your blood, you may need additional treatment.
** It is recommended to prevent pregnancy for one year after removing a molar tissue.