Molar Pregnancy (Hydatidiform Mole): Symptoms and Treatment

A molar pregnancy is an aberrancy of the placenta, caused by chromosomal abnormalities during conception. It forms a mass of abnormal placental tissue inside the uterus, at the beginning of a pregnancy. There are two types of molar pregnancies, complete and partial. Complete molar pregnancy has only placental parts with no fetus, as the sperm fertilizes an empty egg. The placenta grows and generates hCG (human chorionic gonadotropin), a pregnancy hormone, which leads to the misconception that the patient is pregnant. The partial molar pregnancy happens when an egg is fertilized by two sperms. Instead of forming twins, an abnormal fetus and placenta develop, in which the baby has numerous chromosomes and usually dies in the uterus. The potential causes for molar pregnancy can be defects in the egg, abnormalities within the uterus or a diet low in protein, vitamin A and fat.

Symptoms

A molar pregnancy indicates signs similar to the first trimester in a normal pregnancy, like a missed menstrual period, breast tenderness, morning sickness, fatigue and increased urination. Along with normal pregnancy signs, there are many more symptoms of a molar pregnancy which are as follows:

• Abnormal growth of uterus.
• Severe nausea and vomiting.
• Vaginal discharge of tissue shaped like grapes.
• Vaginal bleeding during the first 3 months of pregnancy.
• Pelvic discomfort.
• Signs of hyperthyroidism, such as increased heart rate, fatigue, weight loss, muscle weakness, heat intolerance, sweating, irritability, anxiety and thyroid enlargement.
• Loose stools.
• Trembling hands.
• High blood pressure.
• Swelling in feet, ankles, legs.
• Symptoms similar to preeclampsia which occur during the first trimester. Preeclampsia is the most prominent sign of hydatidiform mole, as it rarely happens in a normal pregnancy.

Diagnose and Treatment
A molar pregnancy can be diagnosed during an early ultrasound test. A pelvic exam (a blood test of pregnancy hormone hCG) and pelvic ultrasound can affirm if a woman is experiencing a molar pregnancy or not. A partial molar pregnancy can also be detected during the treatment of an incomplete miscarriage.

The treatment of molar pregnancy involves the removal of all molar growth from the uterus. Once the uterus is cleared, the patient needs to have regular hCG blood tests, to screen for the signs of interminable cell growth (trophoblastic disease) in the uterus. These tests should be conducted periodically for 6 to 12 months. A woman suspected with a molar pregnancy can be treated by performing a suction curettage (D and C), which is a surgical abortion. A hysterectomy (surgical removal of uterus) can be an option for older women. A woman with a molar pregnancy can also have a benign or non cancerous large ovarian cyst. Sometimes trophoblastic disease may grow into trophoblastic cancer, but it can be cured by chemotheraphy. In rare cases, if there are chances of cancer affecting other parts of the body, aggressive chemotherapy, accompanied with radiation treatment can be used. A woman retains the ability to become pregnant even after the treatment.

Molar pregnancies are more likely to occur in older women, especially after the age of 35 years. Molar pregnancies happen more commonly after a miscarriage, an ectopic (tubal) pregnancy and sometimes even after a normal delivery. Thus, molar pregnancies are 'accidents of nature' and shouldn't be blamed on any one of the partners.