Molar Pregnancy: Causes, Symptoms & Treatment

A molar pregnancy is a complication that is relatively rare and occurs during the process of conception and fertilization. Only one out of a thousand women develop a molar pregnancy and in most cases with immediate medical treatment, there are no long-term risks involved.

When the tissue that ultimately transforms into the fetus develops into an abnormal mass instead, a molar pregnancy has occurred. Also known as a hydatidiform mole, the abnormal growth in the uterus may still trigger off symptoms of a normal pregnancy thereby delaying diagnosis and treatment.

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Causes of Molar Pregnancy
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There are two types of molar pregnancies:

  • Partial molar pregnancy: In a partial molar pregnancy, there is some fetal development along with the abnormal placenta. This may occur when two sperm fertilize one egg resulting in the partial development of the placenta, fetus, and membranes.
  • Complete molar pregnancy: With a complete molar pregnancy, there is no fetus and only an abnormal placenta. This happens when the nucleus of the egg is lost or becomes inactive. In such cases, the uterus is filled with a mole that looks like a bunch of grapes filled with fluid. Since there is no placenta formed, uterine and vaginal bleeding follows.

Causes of a Molar Pregnancy

While the exact cause of a molar pregnancy remains unknown, studies show that the problem originates during the process of fertilization. It may be caused by an ovulation defect or some form of malnutrition in the mother. Other risk factors that may increase the chances of developing a molar pregnancy include:

  • An imbalanced diet that is low in animal fat, vitamin A (carotene) and protein
  • Age over 50 years
  • Clomid stimulation
  • Previous molar pregnancy
  • Early teenage pregnancy
  • A history of miscarriage

Symptoms of a Molar Pregnancy

  • An unpleasant or heavy feeling in the pelvis
  • Vaginal discharge that is shaped like grapes
  • An abnormal growth in the uterus is the first sign of a molar pregnancy. In most cases, the growth is excessive and shows up clearly in an ultrasound. In a few cases, the growth may be smaller than average
  • Severe nausea and vomiting that may even require hospitalization
  • Vaginal bleeding in the first trimester of pregnancy
  • If you suffer from a molar pregnancy, you may also experience symptoms similar to those of preeclampsia such as high blood pressure and swelling in the feet, legs, and ankles. Unlike with preeclampsia where these symptoms only occur in the third trimester, such symptoms occur in the first or second trimester with a molar pregnancy. This is almost always a sure sign of a hydatiform mole.
  •  Increased serum hCG levels
  • The uterus increases in size rapidly
  • Hyperthyroidism symptoms such as feelings of nervousness and fatigue, irregular heartbeat, and excessive sweating
  • Pulmonary Embolism

Diagnosis of Molar Pregnancy

If your doctor suspects a molar pregnancy, he will perform a thorough pelvic examination along with an ultrasound.

Though the normal signs of pregnancy may be evident even with a molar pregnancy, the size of the womb may be irregular along with the abnormal development of the fetus and placenta. The baby's heartbeat is also absent. Other tests include:

  • Blood tests to check hCG levels and CBC
  • Chest x-ray
  • Kidney and liver function tests
  • CT scan or MRI of the abdomen

Treatment of Molar Pregnancy

If the pregnancy has not ended on its own, a D & C or Dilation and curettage procedure will have to be performed. If the woman is older and has no intention of becoming pregnant in the future, a hysterectomy is an option as well.
After such treatment, it is very important to monitor serum hCG levels and to avoid another immediate pregnancy. Care should be taken to use reliable contraception for at least 12 months after molar pregnancy treatment, as women who have had a molar pregnancy are more susceptible to another one in the immediate future.

The prognosis for molar pregnancy treatment is usually excellent. In most cases, the moles are benign or non-cancerous and recovery is speedy. In rare cases, the mole may turn invasive and burrow deep into the walls of the uterus causing other complications such as bleeding, lung problems, thyroid issues, and preeclampsia. The hydatidiform mole may also turn cancerous and develop into a choriocarcinoma.

Coping with a Molar Pregnancy

It can be very frightening to be diagnosed with a molar pregnancy but as long as you receive immediate medical treatment and you follow up on the treatment conscientiously, there is no reason why you can't go on to have successful and healthy pregnancies in the future. Even then, losing a baby at any stage is incredibly difficult for both partners. There needs to be a healing time for everyone involved along with grief counseling if required. Support groups and counselors can provide invaluable help during such tough times.

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