What Is A Complete Molar Pregnancy?

What Is A Complete Molar Pregnancy?

Complete molar pregnancy occurs when the sperm fertilize and empty egg, therefore no fetus is formed, it is just growing abnormal placental cells originated form the paternal side. The placental tissue gets edematous and form fluid filled cysts.

What Is A Complete Molar Pregnancy?

Symptoms And Signs Of Complete Molar Pregnancy

Most women with molar pregnancy would not have any symptoms it is usually from the ultrasound scan only molar pregnancy is diagnosed. The symptoms and signs of complete molar pregnancy and partial molar pregnancy is the same. From symptoms and signs, we cannot distinguish correctly which type of molar pregnancy

  • Vaginal bleeding or spotting
  • Dark color discharge – may contain grape color lumps
  • Nausea and/or vomiting
  • Rapid uterine growth – size of the uterus is larger than the dates

Following symptoms are rare as molar pregnancy is diagnosed by a scan at an early stage

  • Hyperthyroidism
  • Early onset pre-eclampsia
  • Thromboembolism
  • Large ovarian theca lutein cysts

Diagnosis Of Complete Molar Pregnancy

  • Human chorionic gonadotropin (hCG) – very high
  • Ultrasound scan
  • Features of a complete molar pregnancy seen from an ultrasound scan would be:
  • No embryo or fetus
  • No amniotic fluid or gestational sac
  • Complex and echogenic intrauterine mass containing many cystic spaces
  • A thick cystic placenta filling the entire uterus – snow storm appearance (seen with advanced complete molar pregnancy)

Other investigations for complete molar pregnancy

  • Full blood count
  • Clotting profile
  • Liver function test
  • Urea
  • Creatinine
  • Electrolytes
  • Thyroid function tests
  • Chest X-ray
  • Ultrasound Doppler of pelvis

Treatment For Complete Molar Pregnancy

The abnormal tissues should be removed in order to stop it spreading it into other organs and causing complications

Suction evacuation of the uterus is the treatment of choice – this is done under general anesthesia where the abnormal tissues are sucked out by using a thin tube passed into the uterus through the vagina.

Cervical priming can be done immediately prior to evacuation – dilating the cervix so that the suction evacuation can be done easily.
Medical induction not recommended for complete molar pregnancy because of the theoretical risk of myometrial contraction and tumor embolism through the venous system.

Approximately 90% of women undergo molar pregnancy treatment does not need further treatment. After the removal your urine or blood hCG levels will be measured. If hCG becomes normal within 56 days after the pregnancy event then hCG should be measured for 6 months. If it remains elevated more than 56 days then thr hCG levels should be done for 6 months after the normalization of hCG.

Follow up is done to make sure the molar pregnancy is completely removed if not it can grow in the uterus and become a cancer and spread into other organs.

Molar Pregnancy

Molar pregnancy or hydatidiform mole, scientifically known as gestational trophoblastic disease (GTD) is an abnormality of the placental cells (trophoblastic cells which normally develop into the placenta) which occur during the fertilization of the egg and sperm. Abnormal cells or clusters of cells filled with water will grow in the uterus. Molar pregnancies occur 1 in out of every 1000 pregnancies.

Molar pregnancy occurs due to a genetic error during the fertilization process which leads to abnormal tissue growth (abnormal fetal cells) within the uterus. Usually molar pregnancies do not occur in well-developed embryos. These abnormal cells grow rapidly compared to the normal fetal cells and appear as a large “grape-like cell clusters”.

There are two types of molar pregnancy

  • Complete molar pregnancy
  • Partial molar pregnancy

Conclusion

Molar pregnancy or hydatidiform mole, scientifically known as gestational trophoblastic disease (GTD) is an abnormality of the placental cells which occur during the fertilization of the egg and sperm. There are two types of molar pregnancy, complete molar pregnancy and Partial molar pregnancy. Complete molar pregnancy occurs when the sperm fertilize and empty egg, therefore no fetus is formed, it is just growing abnormal placental cells originated form the paternal side. Clinical features cannot distinguish the type of molar pregnancy. In the ultrasound scan features of a complete molar are: no embryo or fetus, no amniotic fluid or gestational sac, a thick cystic placenta filling the entire uterus – snow storm appearance. Treatment would be suction evacuation and follow up of hCG levels for 6 months.

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