A molar pregnancy is a complication that is seen rarely in pregnancy; in which the trophoblasts grow abnormally, compromising the growth of placenta. This condition can be detected with the help of the typical signs and symptoms that it presents and techniques like ultrasound.
How Do You Detect A Molar Pregnancy?
A molar pregnancy can appear as any other normal pregnancy in the beginning. However, it shows some specific signs and symptoms as well. These may include-
- Bright red or dark brown vaginal bleeding, which occurs during the first trimester
- A bad nausea and vomiting
- Passage of cysts through vagina, which may appear to be grape-like
- Immense pelvic pain or pressure
Upon further evaluation, the doctor may find-
- A fast-growing uterus, which does not correspond to the period of gestation
- High blood pressure or hypertension
- Preeclampsia- a condition which exhibits a high blood pressure together with proteinuria after 20 weeks of gestation
- Hyperthyroidism or an overactive thyroid gland
Upon identifying these signs and symptoms, your doctor may order certain tests, to rule out a molar pregnancy-
- He may ask you to do tests that measure the levels of HCG (Human Chorionic Gonadotropin) hormone, which is a pregnancy hormone, present in your blood
- He will ask you to take an ultrasound examination as well.
- An abdominal ultrasound, however, may not suffice since during early pregnancy the uterus and fallopian tubes are much closer to the vagina than the abdomen
- Hence, a trans-vaginal scanning (TVS) can be recommended by your doctor
Your doctor may get the following results in a complete molar pregnancy-
- There is no fetus or embryo
- There is no amniotic fluid as well
- The placenta is thick and shows cysts
- The placenta nearly fills the uterus
- There may also be ovarian cysts
In a partial molar pregnancy, the ultrasound may reveal the following-
- A fetus is seen, but the growth of the fetus is restricted
- Fetus does not correspond to the gestational age
- Amniotic fluid is low in quantity
- The placenta shows cysts and is very thick
Treatment Of Molar Pregnancy
Molar pregnancy needs to be treated on an emergent basis, as the pregnancy cannot be continued as a normal pregnancy due to the risk of complications it may bring. The treatment options may include one or many of the following-
Dilatation and evacuation (D&C)-
- This is a process in which the contents of the uterus are evacuated with the help of a vacuum device
- You will be asked to lie on an operating table and your legs will be positioned in stirrups
- With the help of a speculum, your cervix will be exposed and then dilated with the help of dilators
- Then the contents of the uterus will be removed with the help of a vacuum device
- This means removal of the uterus
- If there is a risk of gestational trophoblastic neoplasia (GTN), and if you do not wish to get pregnant again in future, your doctor may propose the removal of the uterus to prevent any other complications in future
- After the removal of the molar tissue, the doctor will monitor you for the levels of HCG-human chorionic gonadotropin- hormone in your body, as it should come back to normal within a few days of the removal of the molar pregnancy
- Presence of this hormone even after the removal may indicate that some molar tissue may be left behind, which needs to be taken care of
- Your doctor may monitor you for six months to one year, or till your levels come to normal
- Your doctor will advice you to wait for six months to an year to get pregnant again
A molar pregnancy is a complication that occurs very rarely in pregnancy. The typical presentation of this condition is that the trophoblasts grow abnormally. Trophoblasts are the cells that would normally grow and become placenta over time.
- National Institute for Health and Care Excellence (NICE). (2019). Ectopic pregnancy and miscarriage: Diagnosis and initial management. https://www.nice.org.uk/guidance/ng126/chapter/Recommendations#gestational-trophoblastic-neoplasia
- Royal College of Obstetricians and Gynaecologists (RCOG). (2011). The management of gestational trophoblastic disease. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg38/
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