A molar pregnancy or a hydatidiform mole is a chance complication of pregnancy. It occurs due to an abnormal and awry growth of the cells that were to grow and become placenta. The cells are known as trophoblasts. A hydatidiform mole cannot be sustained as a normal pregnancy and needs to be removed with immediate effect, as it can prompt very severe complications.
Complications Of Molar Pregnancy
A molar pregnancy cannot be continued as a normal pregnancy as it can lead to many serious complications, including a rare type of cancer. It needs to be removed immediately. The complications that can occur as a result of molar pregnancy are-
- Following the removal of the molar pregnancy, some defective tissue can remain inside and keep its growth. This is known as persistent GTN – Persistent Gestational Trophoblastic Neoplasia. This happens more in complete molar pregnancies and less in partial molar pregnancies.
- A sign to determine persistent GTN is the presence of very high levels of HCG hormone in urine and blood. HCG is human chorionic gonadotropin hormone, which is a pregnancy related hormone. This hormone occurs at the time of pregnancy and is present throughout the pregnancy. However, after the molar pregnancy is removed, it should disappear from the urine and blood within a few days or weeks. If this does not happen and there is still a presence of this hormone, it may indicate that there is a persistent GTN.
- Another complication is profuse vaginal bleeding, which results if a hydatidiform mole gets deeply rooted inside the wall of the uterus, up to the middle layer.
- Another, a very rare complication of a molar pregnancy is a rare cancer known as choriocarcinoma. It may grow and spread to other body parts. This complication is also found more in the complete molar pregnancy and lesser in partial molar pregnancy.
- Persistent GTN can be efficiently managed with the help of chemotherapy. If not, then hysterectomy – a complete removal of the uterus, stands as another option Choriocarcinoma can also be efficiently managed with the help of different types of cancer drugs
- Another complication that is seen as a result of a molar pregnancy is not due to the condition itself, but because of the procedures used to treat the condition. Hydatidiform mole is removed using a procedure called dilatation and curettage. During this procedure, uterine perforation can occur, as the uterus becomes too bulky and boggy. If perforation is seen, the procedure should be completed under the guidance of laparoscopy.
- Another complication of the treatment procedure of dilatation and curettage is hemorrhage. This is quite a frequent complication. Hence, oxytocin should be administered at the start of the suction process. Methergine should also be available at all times during the procedure, and so should be blood, if a need for transfusion arises.
- Aspects released by the defective tissue can trigger the coagulation cascade. A chance of Disseminated intravascular coagulopathy should not be dismissed and patients should be monitored carefully for any signs and symptoms pertaining to this.
If the uterus of the affected person was larger than what was expected for the gestational age, there is a risk for trophoblastic embolism, which may cause serious respiratory failure. This is especially noted in case of pregnancy of 16 weeks and beyond. The condition can prove to be extremely fatal and needs a prompt management.
A molar pregnancy or a hydatidiform mole is a chance complication of a normal pregnancy. It occurs because of a very improper and awry growth of the cells known as trophoblasts. A molar pregnancy cannot be continued as normal pregnancy and needs to be removed at once, as it can prompt very serious complications, including a very rare type of cancer. The complications of molar pregnancy can prove to be fatal and need to be treated with utmost urgency, and a prompt and efficient treatment.
American Cancer Society. (2021). Gestational Trophoblastic Disease Stages. https://www.cancer.org/cancer/gestational-trophoblastic-disease/about/gestational-trophoblastic-disease-stages.html
Mayo Clinic. (2021). Molar Pregnancy. https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/symptoms-causes/syc-20375167
Lurain, J. R. (2010). Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. American Journal of Obstetrics and Gynecology, 203(6), 531-539. doi: 10.1016/j.ajog.2010.06.073
Lurain, J. R. (2010). Gestational trophoblastic disease II: classification and management of gestational trophoblastic neoplasia. American Journal of Obstetrics and Gynecology, 203(6), 531-539. doi: 10.1016/j.ajog.2010.06.074
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