A molar pregnancy is benign growth which forms as an abnormality of the placenta. In a normal pregnancy, the egg after fertilization gets attached into the walls of uterus and further develops into placenta and fetus. However, in molar pregnancy the placenta develops as an abnormal cystic mass. The condition is also known as hydatidiform mole or gestational trophoblastic disease (GTD).
Molar pregnancy is rare. It may occur in one out of one thousand pregnancies. Molar pregnancies are of two types; complete and partial. In complete molar pregnancy the entire placenta is abnormal which grows at rapid pace.There is no development of baby. In partial molar pregnancy, the egg is fertilized by two sperms.
The part of placenta becomes abnormal while the baby developed has several malformations. Molar pregnancy needs to be treated. Treatment consists of removal of all tissue material from the uterus.
Causes And Risk Factors Of Molar Pregnancy
Molar pregnancy occurs when there is some type of problem in the genetic material in mother’s egg or father’s sperm. Normally when egg gets fertilized, it contains 23 pair of chromosome. One in every pair comes from mother and other from father.However, in complete molar pregnancy all the chromosomes in fertilized egg are from father.
Soon after fertilization the chromosome from mother’s egg is destroyed and duplication occurs in father’s chromosome. The egg will have no genetic material. In partial molar pregnancy, mother’s chromosome is present but from father’s side there are two sets of chromosome. Hence the budding embryo contains 69 chromosomes instead of 23 pairs.
The risk factors for molar pregnancy increases when:
- Age of pregnant woman is more than 35 years.
- Past history of molar pregnancy.
- If there is history of miscarriage.
- If the diet of woman is deficient in carotene, a form of vitamin A and folic acid.
Sign And Symptoms Of Molar Pregnancy
The symptoms of molar pregnancy are similar to those of normal pregnancy in the beginning such as missed period, morning sickness etc. There may be other symptoms too which may include:
- Vaginal bleeding which can be mild. The color of blood can be dark brown or bright red.
- Nausea and vomiting.
- High blood pressure.
- Increased HCG level in blood.
- Fetal movement is absent.
- Fetal heart beat is not heard.
- Discomfort in pelvis. The pregnant woman may complain of too much pressure in the in pelvic region.
- Discharge of grape like tissue from vagina.
- The size of uterus is large as compared to the stage of pregnancy.
- Discharge of too much protein in urine.
- Thyroid gland is overactive.
Management Of Molar Pregnancy
Molar pregnancy cannot continue and the growth needs to be removed from the uterus. It also needs to be removed to prevent any further complications. Sometimes the pregnancy ends spontaneously and grape like cysts are expelled out from the uterus. However, still in any circumstances the dilatation and curettage has to be performed to remove the placental tissue. D&C is often done as an outdoor procedure and does not require any stay in the hospital. However, this will depend on the health condition of the patient.
In case if the woman does not desire any further pregnancies, another option is to remove the uterus which is called hysterectomy. After the molar tissue is removed, the doctor will advice the patient for a regular follow up and to check HCG level in blood for at least one year to ensure there is no more molar tissue left behind in the body.
Patient is also advised to avoid pregnancy for one year. Patient may have to take birth control pills to avoid pregnancy. However, intrauterine device cannot be placed as a birth control option.