Molar pregnancy is a complication of pregnancy. It is characterized by abnormality in placenta that occurs at the stage of fertilization of egg and the sperm. Given below is information on molar pregnancy treatment options.
Molar pregnancy, which is medically referred to as hydatidiform mole, is an abnormal form of pregnancy. This rare complication of pregnancy is classified under gestational trophoblastic diseases. This condition is caused by abnormal fertilization. Scroll down to learn about the different types of molar pregnancy along with the treatment options for the same.
Types of Molar Pregnancy
So how does a normal pregnancy turn into a molar pregnancy? Molar pregnancy is basically an anomaly that could occur during the fertilization process. This condition is characterized by the development of abnormal placental cells, following the fertilization of sperm and the egg. Molar pregnancy is classified into complete molar pregnancy and partial molar pregnancy.
A complete molar pregnancy or hydatidiform mole, develops when the sperm fertilizes an egg that doesn’t have a nucleus. Under normal circumstances, the fertilized egg contains 23 chromosomes from the father as well as the mother. When the egg doesn’t contain DNA, the chromosomes from the sperm duplicate. Since the fertilized egg is bereft of the mother’s chromosomes, normal placental tissue, embryo or amniotic sac wouldn’t be formed.
Under normal circumstances, a layer of cells called trophoblasts develop into finger-like projections called villi. It is this layer of cells that develops into placenta. Due to this chromosomal abnormality, these projections swell up with fluid, and develop into grape-like clusters in the uterus. In case of a partial molar pregnancy, the fertilized egg does contain maternal chromosomes, but the paternal chromosomes are doubled. This may occur when the chromosomes from the sperm duplicate, or the egg is fertilized by two sperms. After fertilization, placental tissue as well as the embryo would develop. This chromosomal abnormality, however, causes the development of abnormal placental cells.
Despite the presence of the fetal tissue, the trophoblastic tissue makes it impossible for the fetus to develop properly. Abnormal growth of uterus, elevated hCG levels, vaginal bleeding in the first trimester, vaginal discharge, nausea, vomiting, pelvic discomfort and fluid retention in lower extremities, are some of the symptoms one may experience due to this condition.
Treatment of Molar Pregnancy
Human chorionic gonadotropin (hCG) is a hormone that is detected in a woman’s blood, a few days after conception. If hCG levels are higher than normal, a pelvic examination is often conducted to rule out molar pregnancy. Imaging procedures such as an ultrasound can also help in detecting the presence of such an abnormal growth within the uterus. Doctors may prescribe drugs that may enable the patient to miscarry the abnormal placental tissue.
The most commonly used partial molar pregnancy treatment option, however, is to have the mole removed through dilation and curettage. Under this procedure, the entrance of the uterus is dilated, and the abnormal growth is either scraped away or suctioned out. Doctors may also conduct a pelvic ultrasound while performing vacuum suction. Dilation and curettage is often used for treating complete as well as partial molar pregnancy. These procedures are performed under anesthesia. Though this condition is usually benign, at times, women who have earlier undergone removal of hydatidiform mole, may become susceptible to trophoblastic cancer.
A majority of women who have been diagnosed with trophoblastic cancer are usually prescribed methotrexate. This is a drug that helps in stopping cancerous cells from growing at a fast rate. It can also lower the risk of trophoblastic cancer in women diagnosed with molar pregnancy. Unlike complete or partial hydatidiform mole, invasive moles grow into the uterine muscle layer. Since these grow into the muscle layer of the uterus, it’s extremely difficult to remove them through dilation and curettage. These may even spread to other parts and need to be treated through chemotherapy.
Women who have undergone chemotherapy as a part of treatment for molar pregnancy are often asked to wait for at least one year, if they wish to conceive. Routine follow-up visits are required after the removal of mole. hCG levels may also be checked every six months. In fact, doctors check for this pregnancy hormone until no traces of hCG show up in blood or urine. If the patient doesn’t wish to conceive in future, doctors may suggest the removal of uterus. Hysterectomy is usually suggested for older women.
Molar pregnancy is a complicated pregnancy that must be diagnosed and treated at the earliest. If an ultrasound and a pelvic exam reveal the presence of abnormal placental tissue, these must be soon removed from the uterus. Though hydatidiform moles are usually benign, one cannot completely rule out the risk of invasive moles.
It is therefore, essential that women, who have suffered from molar pregnancy before, consult a doctor on experiencing such symptoms. Going for pelvic examination or ultrasound annually would certainly help in early detection of this condition.