Molar Pregnancy

What is a molar pregnancy?

It a rare disorder occurring 1 in 1000 pregnancy but is higher in the Asian population. It is also known as gestational trophoblastic disease or mole. There are two type of molar pregnancy i.e complete and partial mole.

Why does a molar pregnancy happen?

It happens due to an abnormal genetic error during the process of fertilization causing rapid abnormal growth of the placenta forming masses of grape like tissues. This abnormal tissue will secrete excess amounts of B HCG (hormones associated with pregnancy)

Who is at risk of getting a molar pregnancy?

  • Mexican , South East Asian and Philipines women.
  • Women > 40 years old
  • History of previous molar pregnancy
  • History of miscarriages

What are the symptoms of a molar pregnancy?

  • Vaginal spotting or bleeding
  • Excessive symptoms of early pregnancy such as nausea and vomiting
  • High blood pressure
  • Symptoms of hyperactive thyroid e.g palpitation, sweating, tremor
  • No fetal heart detected
  • Passing out small grape like tissue from the vaginal

How is the diagnosis of a molar pregnancy made?

  • Physical examination: Your doctor may suspect molar pregnancy if your uterus is soft and larger than your dates
  • Blood test: Your BHCG level will be very high
  • Ultrasound test: There will be a typical appearance of a cluster of grapes on the scan which is known as ‘snow storm’ appearance. Sometimes missed miscarriage will also have similar ultrasound findings but not the high B HCG blood levels.
  • The diagnosis of molar pregnancy could only be confirmed by sending some tissue sample from the womb after D&C

What is the treatment for a molar pregnancy?

    • You will need a D&C (Dilatation and Curettage) if you doctor suspects you to have a molar pregnancy to remove the abnormal tissue from your womb. This procedure could be done under general or regional anaesthetic
    • A Chest X ray will also be done to exclude any spread of the cancerous cell to your lungs.
    • After the diagnosis is confirmed from the tissue sample taken from your womb. You will need to be followed up closely by your doctor to monitor the level of your BHCG to ensure that the mole has been removed completely. This may be for the next 1 to 2 years.
    • If your BHCG does not return back to normal, then you may require chemotherapy. About 90% of women do not require any more treatment following the D&C
    • Your doctor will generally advised you not to get pregnant till your levels come back to normal for at least 1 year.
    • You need to follow your doctor’s advice and closely be monitored because with appropriate treatment nearly 100% of cases could be completely cured especially if is has not spread outside the womb. Even if is has spread outside the womb, 80 – 90% of cases is still curable with chemotherapy.

What is my risk of getting another molar pregnancy in future?

Your risk is about 1 – 2% of getting another molar pregnancy.

Will the molar pregnancy affect my future fertility and baby?

No the molar pregnancy does not affect your future fertility or ability to have a normal pregnancy even after chemotherapy. In addition, it will not cause abnormalities in your future baby.
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