Molar pregnancy is an unusual and severe complication of pregnancy. Medically referred to as hydatidiform mole, it is a type of gestational trophoblastic disease (GTD). The article throws light on the symptoms and treatment of such a pregnancy.
A molar pregnancy is an aberrancy of the placenta caused by chromosomal abnormalities during conception. It forms a mass of abnormal placental tissue inside the uterus, at the beginning of a pregnancy. There are two types of molar pregnancies, complete and partial. Complete pregnancy has only placental parts with no fetus, as the sperm fertilizes an empty egg.
The placenta grows and generates hCG (human chorionic gonadotropin), a pregnancy hormone, which leads to the misconception that the patient is pregnant. The partial pregnancy happens when an egg is fertilized by two sperms. Instead of forming twins, an abnormal fetus and placenta develop, in which, the baby has numerous chromosomes and usually dies in the uterus. The potential causes for this kind of pregnancy, can be defects in the egg, abnormalities within the uterus, or a diet low in proteins, vitamin A, and fat.
A molar pregnancy indicates signs similar to the first trimester in a normal pregnancy, like a missed menstrual period, breast tenderness, morning sickness, fatigue, and increased urination. Along with normal pregnancy signs, there are many more symptoms, which are as follows:
- Abnormal growth of the uterus
- Severe nausea and vomiting
- Vaginal discharge of tissue shaped like grapes
- Vaginal bleeding during the first 3 months of pregnancy
- Pelvic discomfort
- Signs of hyperthyroidism, such as increased heart rate, fatigue, weight loss, muscle weakness, heat intolerance, sweating, irritability, anxiety, and thyroid enlargement
- Loose stools
- Trembling hands
- High blood pressure
- Swelling in feet and ankles
- Symptoms similar to preeclampsia, which occur during the first trimester. Preeclampsia is the most prominent sign of hydatidiform mole, as it rarely occurs in a normal pregnancy.
Diagnosis and Treatment
Hydatidiform mole can be diagnosed during an early ultrasound test. A pelvic exam (a blood test of the pregnancy hormone hCG) and pelvic ultrasound can affirm if a woman is experiencing a molar pregnancy or not. A partial type of this pregnancy can also be detected during the treatment of an incomplete miscarriage.
The treatment involves removal of all molar growth from the uterus. Once the uterus is cleared, the patient needs to have regular hCG blood tests, to screen for the signs of interminable cell growth (trophoblastic disease) in the uterus. These tests should be conducted periodically for 6 to 12 months. A woman suspected with a molar conception, can be treated by performing a suction curettage (D and C), which is a surgical abortion. A hysterectomy (surgical removal of uterus) can be an option for older women.
A woman can also have a benign or non cancerous large ovarian cyst. Sometimes, trophoblastic disease may grow into trophoblastic cancer, but it can be cured by chemotheraphy. In rare cases, if there are chances of cancer affecting other parts of the body, aggressive chemotherapy, accompanied with radiation treatment can be used. A woman retains the ability to become pregnant even after the treatment.
Molar pregnancies are more likely to occur in older women, especially after the age of 35 years. This abnormal conception happens more commonly after a miscarriage, an ectopic (tubal) pregnancy, and sometimes, even after a normal delivery. Thus, they are ‘accidents of nature’ and shouldn’t be blamed on any one of the partners.