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Molar Pregnancy: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Complication and Prevention: OBGYN

Aug 01, 2023

Molar pregnancy

A molar pregnancy is a rare pregnancy complication. Trophoblasts are involved, which grow in a unique manner. A developing fetus is often fed by an placenta which is an organ made from trophoblasts.

There are two different types of molar pregnancy complete molar pregnancy and partial molar pregnancy. A full-term molar pregnancy causes the placental tissue to expand and appear to develop cysts that are filled with fluid while there is no embryo.

There may be both normal and irregular tissue in the placenta of a partially molar pregnancy. A fetus could exist, but it wouldn't survive. An early stage of pregnancy is usually when a miscarriage happens.

One of the serious issues that could result from a molar pregnancy is an uncommon type of cancer. So for a molar pregnancy, early intervention is required.

Causes Of Molar Pregnancy

An abnormally fertilized egg results in a molar pregnancy. The human cell contains 23 pairs of chromosomes. Typically, each pair of chromosomes receives one from the father and one from the mother during fertilization.

An egg is fertilized by one or two sperm during a complete molar pregnancy. The mother's egg's chromosomes are either absent or dysfunctional. Chromosomes from the father are duplicated. Nothing from the mother.

The mother's chromosomes are present in a partial or incomplete molar pregnancy, while the father contributes two sets of chromosomes. Instead of 46, the embryo now has 69 chromosomes. An additional copy of the father's genes is produced when two sperm fertilize an egg, which happens most frequently.

Symptoms Of Molar Pregnancy

A molar pregnancy may initially appear to be a normal pregnancy. However, most molar pregnancies result in symptoms, which can include

  • During the first three months, there may be dark brown to bright red vaginal bleeding.
  • Vomiting and severe nauseousness.
  • Sometimes, grape-like cysts emerge from the vagina.
  • Pelvic discomfort or pressure.

Most molar pregnancies are discovered in the first trimester as a result of improved methods for detecting them. The following signs of a molar pregnancy could be present if it is not discovered within the first three months:

  • In early pregnancy, there is a rapidly expanding, excessively big uterus.
  • Before 20 weeks of pregnancy, a disease called preeclampsia occurs, which results in high blood pressure and protein in the urine.
  • An ovarian cyst.
  • Thyroid hyperactivity which  is also referred to as hyperthyroidism.

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Risk Factors Of Molar Pregannacy

A molar pregnancy may result from a number of factors, including:

  • Earlier molar pregnancy. You are more likely to experience another molar pregnancy if you've already experienced one. One in every 100 people experiences a recurrent molar pregnancy.
  • Mother's age. A molar pregnancy is more prevalent in adults over the age of 43 or under the age of 15.

Diagnosis Of Molar Pregnancy

An ultrasound and blood tests are likely to be requested by a doctor who suspects a molar pregnancy. A wand-like device may be inserted into the vagina during an early pregnancy ultrasound.

The following could be seen on an ultrasound of a full molar pregnancy as early as eight or nine weeks of pregnancy:

  • No foetus or embryo
  • Lack of amniotic fluid
  • A big, cystic placenta that is virtually full of ovaries

An ultrasound during a pregnancy with a partial molar might shows:

  • Smaller than anticipated foetus
  • Minimal amniotic fluid
  • Unusual-looking placenta

When a molar pregnancy is discovered, a medical professional may also look for additional conditions, such as:

Treatment Of Molar Pregnanacy

A molar pregnancy must not be allowed to continue. To prevent difficulties, the injured placental tissue must be removed. The bulk of treatments consist of the following steps:

  • Dilation and curettage, or D&C. During this procedure, the uterine molar tissue is removed. Patient lie  back on a table with legs in stirrups and  receive drugs that will put the patient  to sleep or will cause numbness.
  • After opening the cervix, the medical expert utilises a suction device to remove uterine tissue. A D&C for a molar pregnancy is normally carried out in a hospital or surgical centre.
  • Removing the uterus. This rarely occurs if there is no intention for more pregnancies and there is a higher risk of gestational trophoblastic neoplasia (GTN).
  • HCG monitoring. Once the molar tissue has been removed, the HCG level is monitored until it starts to decline. Additional treatment might be necessary if the blood's HCG concentration remains high.

A physician could monitor HCG levels for six months after the molar pregnancy therapy is finished to be sure no molar tissue is still present. HCG levels are monitored for a year after chemotherapy in patients with GTN.

An expert might advise waiting 6 to 12 months before trying to get pregnant again because pregnancy HCG levels also rise throughout a typical pregnancy. During this time, the healthcare provider can suggest an effective method of birth control.

Complications Of Molar Pregnancy

Molar tissue may still exist and develop after a molar pregnancy has been removed and it is condition is known as persistent gestational trophoblastic neoplasia (GTN). GTN occurs more frequently in complete molar pregnancies than in partial molar pregnancies.

A high level of the pregnancy hormone human chorionic gonadotropin (HCG) after the molar pregnancy has been eliminated is one indication of persisting GTN. The mole that causes the molar pregnancy might occasionally penetrate all the way to the uterine wall's middle layer. The vagina bleeds as a result of this.

Chemotherapy is frequently used to treat persistent GTN. The removal of the uterus, often known as a hysterectomy, is an additional therapy option.

Rarely, choriocarcinoma, a malignant variation of GTN, can form and metastasize to additional organs. Chemotherapy is typically effective in treating choriocarcinoma. This issue is more likely to occur in a complete molar pregnancy than in a partial molar pregnancy.

Prevention Of Molar Pregnancy

If you've had a multiple pregnancy, consult your gynaecologist before trying to conceive again. Perhaps you should hold off for six to a year. The likelihood of experiencing another molar pregnancy is low, but after one, the likelihood increases.

Early ultrasounds throughout subsequent pregnancies may be performed by a healthcare professional to monitor your health and ensure the baby is growing normally.

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