What Is A Partial Molar Pregnancy?
Partial molar pregnancy occurs when the egg is fertilized by two sperms. The zygote therefore, become triploid containing 69 chromosomes. One set of chromosomes from the mother and 2 sets of chromosomes form the father. The mass contains both abnormal and normal placental cells and an embryo with severe birth defects. The abnormal cells grow rapidly overcoming the fetus. A very rare version of partial mole is twins are formed from the fertilization and one embryo grows normally while the other becomes a mole. The abnormal cells will overcome the normal embryo quickly with time.
Symptoms And Signs Of Partial Molar Pregnancy
Most women with molar pregnancy would not have any symptoms, it’s 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 the 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 Partial Molar Pregnancy
- Human chorionic gonadotropin (hcg) – very high
- Ultrasound scan
- Enlarged or thickened placenta compared to the uterine size
- Cystic spaces within the placenta
- An alive or dead well-formed but deformed fetus
- An empty gestational sac or a sac with an ill-defined fetal echo
Other investigations for partial 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 Partial Molar Pregnancy
Suction evacuation is the best treatment option for partial molar pregnancy; however, if the fetal parts are large it can deter the use of this method.
Medical treatment can be considered for partial molar pregnancies detected in the second trimester. Since, the fetal parts obstruct the suction evacuation it’s easy to medically remove the tissues, the risk of recurrence is also less in this method.
In case of heavy bleeding during the procedure, oxytocin can be given preferably after the evacuation has been completed
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 hCG levels should be done for 6 months after the normalization of hCG.
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 is an abnormality of the placental cells which occur during the fertilization of the egg and sperm. There are two types of molar pregnancy partial molar pregnancy and complete molar pregnancy. Partial molar pregnancy occurs when the egg is fertilized by two sperms. The zygote therefore, become triploid containing 69 chromosomes. The mass contains both abnormal and normal placental cells and an embryo with severe birth defects. The abnormal cells grow rapidly overcoming the fetus. Clinical features cannot distinguish the type of molar pregnancy. Suction evacuation is the best treatment option. Medical treatment can be considered for partial molar pregnancies detected in the second trimester. Since, the fetal parts obstruct the suction evacuation it is easy to medically remove the tissues, the risk of recurrence is also less in this method.
- American College of Obstetricians and Gynecologists (ACOG): https://www.acog.org/womens-health/faqs/molar-pregnancy
- Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/symptoms-causes/syc-20375169
- Medscape: https://emedicine.medscape.com/article/266598-overview
- National Organization for Rare Disorders (NORD): https://rarediseases.org/rare-diseases/molar-pregnancy/
- Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/17941-molar-pregnancy
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