Molar Pregnancy:
Miscarriage
Molar pregnancy is a type of gestational trophoblastic disease. It can refer to either a complete
or partial mole. It is an amount of tissue (hydatidiform mole) that forms a placenta
abnormally inside the uterus. Beginning with 2-3 sets of the father's chromosomes and none from
the mother, these types of pregnancies can easily trigger symptoms of pregnancy. 1 in 1000 women that
experience early pregnancy symptoms has a molar pregnancy.
Complete Mole
A complete mole happens when the nucleus of an egg is lost or inactivated. Self Duplication
of the sperm then happens because of lack of genetic information. The hydatidiform mole
grows into a grape like cluster that can fill the uterus. There is no placenta, no fetus,
no amniotic membranes and no fluid.
The grape like vesicles grow rapidly, which can make the uterus seem larger than it should
be for gestational age. This can be picked up by ultrasound. Since there is no placenta
to receive the blood, you may see bleeding into the uterine cavity or
vaginal bleeding.
Partial Mole:
This happens when two sperm fertilize the same egg. When partial mole occurs, there may be
partial placentas, a fetus or membranes present. Genetic problems with the baby are usually
present in partial mole pregnancies.
Who is at risk?
~ In the US, 1 out of 1000 pregnancies is molar.
~ White women in the US have a higher risk than Black women.
~ Women over 40 years old.
~ Women with miscarriage history.
~ Women who previously had a molar pregnancy.
~ Women in the Philippines, Mexico, Southeast Asia have higher rates than the women in the US.
What are the symptoms?
First trimester pregnancy symptoms
are usually experienced. This includes a missed period,
fatigue, tenderness/ soreness of breasts, increased urination and
morning sickness.
Molar
pregnancies can be diagnosed by an ultrasound. Other symptoms can include:
~ Vaginal bleeding
(light or heavy flow).
~ Vaginal discharge of grape shaped tissue.
~ Pelvic discomfort.
~ An abnormally large uterus for the gestational age.
~ No fetal movement or hear tone detected.
~ Increased Nausea and vomiting.
~ hyperthyroidism signs: Weight loss, heat intolerance, increased heart rate, irritability,
sweating,
anxiety,
thyroid enlargement and muscle weakness.
Diagnosis:
Typically, a molar pregnancy will spontaneously end in
miscarriage.
When the woman passes the grape like tissues
and shows them to her doctor then a molar pregnancy is suspected.
When diagnosing through an ultrasound, a “snow storm effect" on the screen is visible.
Serial hCG levels can show a rapid rise in hCG that may indicate that further study is needed.
Treatment:
If the pregnancy has not ended on its own, a D & C is done. This procedure evacuates the mole
from the uterus. A hysterectomy is offered if the woman wishes to discontinue childbearing.
Typically, labor induction is not recommended as excessive bleeding can occur. As a follow up,
hCG levels are checked on a schedule until levels are normal. This checking of levels is done
for approximately 3 weeks. After, monthly checks will be done for six months, then every two months
until a full year of testing has taken place. If a rising of hCG levels and a uterus that is
enlarging happens, this could indicate choriocarcinoma. Along with level testing, pelvic exams
should also be performed.
*Pregnancy should be avoided for a full year. Your doctor may recommend a method of birth control
that is not an iud to aid in prevention.
Click here for Miscarriage
Click here for Blighted Ovum
Click here for Chemical Pregnancy
Click here for Ectopic Pregnancy
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