Molar Pregnancy (Hydatidiform Mole)

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Molar pregnancy or hydatidiform mole is a pregnancy complication where there is abnormally-forming placental tissue that causes the fetus to barely grow in the uterus or not grow at all. The egg and placenta that fail to grow in the uterus later become a collection of cysts or bubbles that looks like grapes.

Molar pregnancy is a rare complication of pregnancy and can be difficult to detect, as the symptoms are nearly similar to normal pregnancy. You will need to schedule regular consultation with an obstetrician to detect the possibility of molar pregnancy. 

Types of Molar Pregnancy

There are two types of molar pregnancy namely: 

  • Complete molar pregnancy. In this pregnancy, abnormal and swollen placental tissue will form a cluster of fluid-filled cysts. Additionally, there is no formation of fetal tissue. 
  • Partial molar pregnancy. In this pregnancy, there may be a formation of normal and abnormal placental tissue. There may also be a formation of a fetus, but the fetus is not able to survive, resulting in early miscarriage.

Causes of Molar Pregnancy 

Complete formation of a normal fetus requires a balanced amount of 46 chromosomes (23 from sperm and 23 from egg cells) and must not be empty. Imbalanced chromosomes will lead to the risk of molar pregnancy. The causes of molar pregnancy can be divided into two types, namely:

  • Causes of complete molar pregnancy. An empty egg is fertilized by one or two sperm, and all cells will be formed from the father’s genes. This condition causes the mother’s egg to be inactivated, yet the chromosomes from the father are duplicated. From here, the fetus fails to form and grows in the uterus, but the placental tissues continue to grow abnormally.
  • Causes of partial molar pregnancy. The mother’s chromosomes remain complete, but the father provides two sets of chromosomes resulting in the embryo having 69 chromosomes instead of 46. This condition causes the fetus formation in the uterus to not survive or die early in pregnancy.

When to See a Doctor about Molar Pregnancy? 

An obstetrician has the ability to diagnose molar pregnancy. If your doctor suspects a possibility of molar pregnancy, your doctor will perform a series of blood tests, including a pregnancy test to measure levels of HCG (a natural hormone of the placenta) and ultrasound scan.

In complete molar pregnancy, there are several things that can be detected via ultrasound scan at the 8th or 9th week of pregnancy:

  • Ovarian cysts.
  • No amniotic fluid.
  • The thickness of the placenta nearly fills the entire uterus.
  • No formation of embryo or fetus in the uterus.

As for partial molar pregnancy, there are several things that can be detected via ultrasound scan, namely:

  • Low  amniotic fluid 
  • Abnormal fetal growth
  • Thick placenta

Your doctor will likely perform a physical exam and run several other tests in addition to blood tests and ultrasound scan. Your doctor will ask you a number of questions such as:

  • Are you in pain?
  • When was your last menstrual period?
  • When did you first begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • Have you had a past molar pregnancy ?
  • Compared with your heaviest days of menstrual flow, is your bleeding more, less or about the same? 

Make sure you provide honest answers for all the questions asked by your doctor. It will make things easier for the doctor to diagnose and provide the right treatment for you. 

Symptoms of Molar Pregnancy 

Molar pregnancy may be difficult to detect early in pregnancy, as the symptoms are similar to normal pregnancy. However, there are some common symptoms of molar pregnancy that you should be aware of, such as:

  • Size of the stomach exceeds gestational age
  • Severe nausea and vomiting. 
  • Pelvic pressure or pain
  • An unusually swollen tummy
  • Dark brown to bright red vaginal bleeding during the first trimester

If you experience any signs or symptoms of a molar pregnancy, consult your doctor or pregnancy care provider in order to detect other signs of a molar pregnancy such as:

  • Ovarian cysts.
  • Overactive thyroid (hyperthyroidism).
  • Rapid uterine growth — the uterus is too large for the stage of pregnancy
  • Preeclampsia, a condition that causes high blood pressure and protein in the urine after 20 weeks of pregnancy

Treatment for Molar Pregnancy

Women who have molar pregnancy will experience spontaneous miscarriage. This miscarriage will release a lump-shaped tissue filled with fluid that resembles white grapes. 

It will be a different case if you have never had a  miscarriage, as the doctor will do follow-up procedures to prevent complications. Procedures provided by the obstetrician to deal with molar pregnancy include:

  • Dilation and curettage. A surgical procedure to remove the remaining tissue in the uterus (curettage) by performing a cervical opening and cutting the tissue around the uterus. Curette can be an option if you plan to get pregnant again. 
  • Hysterectomy. A surgical procedure to remove a woman’s uterus. Hysterectomy can be an option if you have no desire for future pregnancies and at the same time prevent dangerous diseases that may appear after pregnancy. However, it should be noted that hysterectomy is a major operation, which requires a relatively long time to recover.
  • HCG. Even though you have undergone a curette procedure, it is possible that there are abnormal cells left in the uterus that will disappear within a few months. However, in some cases, it requires further treatment to completely remove the abnormal cells. Your doctor will monitor the levels of HCG levels (the placenta’s natural hormone) to make sure the abnormal cells in the uterus have completely disappeared.

Treatment Costs for Molar Pregnancy 

The treatment costs for molar pregnancy may vary, depending on the treatment method recommended by the doctor, the location of treatment, and the hospital. The costs for curettage and hysterectomy procedures are certainly different.

For more information regarding the estimated cost of curette or hysterectomy procedure, contact Smarter Health. 

Prevention of Molar Pregnancy 

Molar pregnancy can occur due to gene errors,which can be very difficult to prevent. However, there are some things you can do to prevent the occurrence of molar pregnancy in the next pregnancy, as someone who has experienced molar pregnancy is likely to experience it again in the future.

One way to prevent molar pregnancy is to delay pregnancy – at least one year after you had curettage. You can use contraceptives such as birth control pills (except spiral birth control) to delay pregnancy.

Moreover, you can do routine ultrasound scans to monitor the development of the fetus.

Home Remedies for Patients Diagnosed with Molar Pregnancy

If you opt for a curettage procedure, you will be able to do daily activities a few days after the procedure. However, if you choose a hysterectomy, it will take longer to recover.

It is normal to feel sad and devastated after losing your child. Give yourself time to grieve. Do not hesitate to share what you feel. Turn to the people closest to you to talk about your feelings or see a psychologist to get the best solution.

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