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Molar pregnancy image

What is a Molar Pregnancy?

Molar pregnancy or also known as-‘hydatidiform mole’, is a rare form of non-viable pregnancy. That is, it cannot sustain itself and rather, must be removed at the earliest possible. 

 

This is because, in this type of pregnancy,  the embryo doesn’t develop into a child. Rather both-, the fetus and the placenta, rapidly grow in the form of a benign tumor. Because of its rapid growth, the uterus enlarges abnormally, causing acute pain, bleeding, cramping, nausea, and at times, grape-sized cyst-like expulsions from the vaginal passage. 

 

If left untreated, it poses grave risks to the mother’s health, including, turning into a rare form of cancer, and bleeding until death.

molar pregnancy causes

Why Does it Happen?

A molar pregnancy can happen because of multiple reasons including- 

 

  • Fertilization of an empty egg.

 

  • Double fertilization of female cell (That is, the fertilization of an ovum by 2 sperms instead of 1. Thereby, leading to 69 chromosomes in the embryo instead of the normal 46. )

 

  • The genetic tendency of the male sperm to grow abnormally faster than normal. Thereby, turning into a benign tumor rather a viable pregnancy.

Types of Molar Pregnancy

Partial Mole Ectopic Pregnancy

Partial Mole Pregnancy

 Complete Mole Ectopic Pregnancy

Complete Mole Pregnancy

Risk Factors

  • Maternal Age (less than 20 or more than 40 years)
  • Race (Asian women are at a higher risk)
  • Genetics ( Family history of Gestational Trophoblastic Disease)
  • Previous molar pregnancy or GTD
  • Diet (Deficiency of folate, beta-carotene or protein)
  • Infection (sepsis of the blood or the uterus)
  • Preeclampsia (Very high blood pressure)

Symptoms

  • Severe nausea and vomiting
  • Pelvic pressure or pain
  • Dark brown to bright red vaginal bleeding during the first trimester
  • Vaginal passage of grape-llike cysts

Diagnosis

  • Transvaginal/ Abdominal ultrasound

Procedure: Both transvaginal and abdominal ultrasounds are simple, 7-10 minutes imaging tests, that is,  the tests that provide an internal image of the body organ using high-frequency sound waves. 

 

However, as the name suggests, transvaginal ultrasound is done by inserting the sound wave device through the transvaginal cavity, whereas the abdominal ultrasound is done through the abdominal surface. Since the sound wave device is closer in transvaginal ultrasound, it can help pick up the type of pregnancy earlier and is more accurate than the results of an abdominal ultrasound. 

 

Confirmation: The shape and type of the fetus and placenta confirm the type of pregnancy. In the case of partial molar pregnancy, the fetus often looks abnormally small for its age along with low amniotic fluid and abnormal placenta. In a case of complete molar pregnancy, the fetus is absent with only a cystic placenta.  In both types, the uterus too grows exceptionally larger than the one at that particular stage of pregnancy

 

  • HCG levels

 

Procedure:  HCG stands for Human Chorionic Gonadotropin. It is a pregnancy hormone that grows with advancement in pregnancy.  It is tested through a laboratory urine test. 

 

Confirmation: In contrast to a normal pregnancy, the level of HCG is exceptionally high during molar pregnancy. At times,  reaching thousands.  

Transvaginal Ultrasound

Severity

If a molar pregnancy is not treated in time or the expulsion remains incomplete, it can advance and cause serious complications including gestational trophoblastic neoplasia (GTN) or persistent GTD, that is, persistent growth of the abnormal placental tissue. 

 

In case, it is an invasive mole, the tumor can spread into the wall of the uterus and severe the range of complications and bleeding. 

 

At times, the benign tumor can develop into a rare form of cancer and necessitate hysterectomy, chemotherapy, or other treatments.

gestational trophoblastic disease (GTD)

Risks & Complications

The D&C procedure (dilation and curettage) followed by methotrexate medicine is one of the safest and most successful methods for removing the molar pregnancy. The risks are mostly mild and easily manageable. These include-

 

  • General anesthetic complications
  • Excessive bleeding
  • Blood clotting

  • Next pregnancy after molar pregnancy

    Effect on Future Pregnancy

    Next pregnancy after molar pregnancy

    There is a fair 50-50 chance of both- healthy and unhealthy pregnancy after an episode of molar pregnancy. However, it is strictly advised that you try conception only after 6-12 months of the last procedure to reduce the risk of any kind of non-viable pregnancy including stillbirths, miscarriages, molar pregnancy and so. 

     

    Doctors suggest that it is best that you stay alert for signs and symptoms of the next pregnancy and take an ultrasound exam within 8-9 weeks of the missed period to avoid any complications. 

     

    You can read more about different case studies  here

  •  Myths and Facts about Molar Pregnancy

    Myths and Facts

     Myths and Facts about Molar Pregnancy
    • Molar Pregnancy is a woman’s fault. 

    No. Molar pregnancy is no one’s deliberate doing. If anything, it is a genetic defect that may happen because of both or either male/ female partner. 

     

    • Molar Pregnancy is always cancerous.

    No. Though molar pregnancy does increase the risk of cancer by 30%, it is not always cancerous. In most cases, it can be easily managed through the D&C procedure. 

     

    • Women with molar pregnancies cannot conceive naturally. 

    False. While normal pregnancy is slightly difficult in partners who have earlier had a molar pregnancy, it is not entirely impossible. In fact, reports suggest a fair 50% chance at natural conception. However, do consider another pregnancy only after 6-12 months of the procedure. And if need be, consult your gynecologist for other options through assisted reproductive technology.  

     

  • Prevention-of-Molar-Pregnancy

    Prevention

    Prevention-of-Molar-Pregnancy

    Unfortunately, molar pregnancy cannot be avoided through any specified methods. However, you can follow the following guidelines to reduce the risk and complications to a certain level:

     

    • Avoid pregnancy at an early teen or later than 40 years of age. (for females)

     

    • Avoid pregnancy until 6-12 months after a case of molar pregnancy. 

     

When To Consult a Doctor

Consult your gynecologist as soon as you experience :

  • The first sign of pregnancy (missed period)
  • Abnormal vaginal bleeding 
  • Pain/ pressure in the abdomen or pelvis
  • Nausea/ lightheadedness
  • Sudden and acute pain in the abdomen
  • Grape like cystic expulsions through the vagina 

Questions To Ask Your Doctor

What type is my molar pregnancy- a complete mole or partial mole?
What are my treatment options?
What is better for removing molar pregnancy- medicines or D&C?
Why does molar pregnancy happen?
How can I prevent molar pregnancy in the future?
What are my chances of healthy conception through natural methods?
What are my other fertility options?
What are the different modes of payment accepted?
Which insurances do you accept?

Treatment Options & Cost

While termination of molar pregnancy is possible through medicines, it is not commonly preferred because of the longer treatment method, continuous need for monitoring, and repeated follow-ups. Medical management also runs an elevated risk of incomplete abortion and repeat molar pregnancy. 

 

However, if the molar pregnancy is detected earlier in the cycle, and the patient favors medical management, the following may be employed:

 

Medicine: Methotrexate

 

Procedure: Methotrexate is given directly by an injection in one dose. hCG levels are monitored before and after the procedure. If the levels do not decrease after the first dose, a second dose may be needed. Confirmation of termination is taken through ultrasound. 

 

Side effects: Some of the side effects include- 

  • Abdominal pain 
  • Vaginal bleeding
  • Nausea
  • Vomiting
  • Diarrhea
  • Dizziness

Cost: The medical management of molar pregnancy typically costs between Rs. 2000 to Rs. 3000 in India.

Insurance Coverage for molar pregnancy

Insurance Coverage

Yes, insurance covers the surgical treatment cost for molar pregnancy as it falls under the ‘medically necessary’ list of treatments. However, the specifics may vary from policy to policy. Please confirm the same from your healthcare or insurance provider.

Insurance Coverage for molar pregnancy
Recovery after Molar Pregnancy

Recovery Rate

Be it medical or surgical treatment for molar pregnancy, it may take several weeks for you to recover completely. Through this time you may feel mild but constant abdominal pain or discomfort. It may take some time for your body to adapt to the changes and the period cycle to return to normal.

Recovery after Molar Pregnancy

Video testimonial - by patient

Video on the disease and treatment - by Pristyn Care doctor

Latest Research and News

  • Latest Research and News on Molar Pregnancy

    NIH’s biometric analysis of molar pregnancy in the last 50 years:

  • Latest Research and News on Molar Pregnancy

    News Med article on rare genes responsible for recurrent molar pregnancies-

     

  • Latest Research and News on Molar Pregnancy

    A case report by NIH on recurrent molar pregnancies in India and the Middle East:

  • Latest Research and News on Molar Pregnancy

    Hindawi article on incidence and management of molar pregnancy in Tertiary care hospital, Pakistan

  • Latest Research and News on Molar Pregnancy

    LWW journal on the management of molar pregnancy:

  • Latest Research and News on Molar Pregnancy

    Oatext case report on molar pregnancy

  • Latest Research and News on Molar Pregnancy

    Oxford Academic on subsequent pregnancies after molar pregnancy:

FAQ

How common is a molar pregnancy?

Globally, one in every 1000 pregnancies is a molar pregnancy. However, NIH reports that the cases of molar pregnancy are much higher in India, that is- one in every 160 pregnancies.

Can molar pregnancy happen twice?

Yes. Reports suggest that 1 in every 100 women may have a repeat case of molar pregnancy if they have had it before.

What is the most common type of molar pregnancy?

Data reports that ‘complete molar pregnancy is a more common type of pregnancy than ‘partial molar’ pregnancies.

When is molar pregnancy most common?

Molar pregnancy is most common in early teens or with women in their forties.

Can the baby be saved in molar pregnancy?

No. The baby cannot be saved in a molar pregnancy as the embryo never grows into a normal fetus or placenta. The pregnancy is nonviable. However, in a rare case, NIH reported that “A fetus with a partial mole may survive when it occurs in a dizygotic twin, with one fetus and the other oocyte giving rise to a partial diploid mole, however, a monozygotic twin with triploidy gives rise to a partial mole with an abnormal fetus.” It also reported, “ a twin pregnancy with a hydatidiform mole and a coexisting live fetus requires a thorough evaluation, and pregnancy may be continued under close surveillance for an optimal outcome.” You can read more about it here.

Can women die because of molar pregnancy?

Yes, if the molar pregnancy is not removed in time, the woman may bleed to death or develop a rare form of cancer known as- gestational trophoblastic neoplasia (GTN).

Which type of doctor removes molar pregnancy?

A gynecologist is the most ideal doctor to remove molar pregnancies. A substantial experience of handling prior cases of molar pregnancies or gestational trophoblastic neoplasia (GTN ) is even better.

What is favored more- medical or surgical removal of molar pregnancy?

Surgical removal of molar pregnancy is the most favored method of pregnancy termination because of its immediate and confirmed results.

Is removal of molar pregnancy an emergency treatment?

Yes. If the complications are intense or the surgery is performed in the latter weeks of pregnancy, that is, when the bleeding is intense or there is an elevated risk of the pregnancy turning into gestational trophoblastic neoplasia (GTN), it falls under the ‘emergency’ bracket of surgeries. Otherwise, it is mostly an ‘elective’ procedure.

What are the chances of a healthy pregnancy after molar pregnancy?

Your chances of a healthy conception despite an earlier molar pregnancy are roughly 50%

How long should I wait before trying to become pregnant again?

Typically, doctors suggest you wait at least 6- 12 months before trying to conceive again after molar pregnancy.

When can I have sex after molar pregnancy treatment?

You can indulge in sexual intercourse after 2 weeks of your treatment. However, make sure you use contraceptives. Else, a pregnancy before at least 6-12 months after a molar pregnancy has a high chance of turning nonviable.

Why choose Pristyn Care for molar pregnancy treatment?

Pristyn Care brings the most advanced and holistic gyne treatments with its experienced doctors and latest laparoscopic and laser technology in 15+ cities in India. We are associated with multiple reputed gyne-clinics and super-specialty hospitals, giving you the option to choose amongst the best hospitals that suit your needs, be it the hospital distance, its infrastructure, or insurance panel. 

 

As you choose Pristyn Care for your treatments, you get some of the added benefits.  These include:

 

  • Free online/ in-clinic consultations: We offer free consultations. Also, you have the choice to speak with the doctor in-clinic or offline, sitting from the comfort of your home. You can ask as many questions, and we ensure we give you the right and detailed answers. 

 

  • Free transportation to and from the hospital: We provide free cab pick up and drop off from and to your residence on the day of surgery.

 

  • Minimal-no waiting time for hospital admission: We perform most of our admission formalities beforehand, so you do not have to wait for hospital admission at the site. 

 

  • All paperwork done on your behalf: We do all your hospital admission and discharge paperwork ourselves on your behalf to reduce your hassles and provide a seamless patient experience. 

 

  • Multiple payment options: We accepts all modes of payment including cash, credit, and debit card. 

 

  • All insurances accepted: We accept all insurances and offer cash-less facilities at most of the hospitals. 

 

  • No cost EMI option: You can also opt for the No cost EMI option while paying for your medical bills. 

 

  • Free follow-up: We provide free follow-up post consultations to ensure a complete and smooth recovery. 

 

How to book an appointment with a Pristyn Care Gynecologist for molar pregnancy?

 

Booking an appointment with a Pristyn Care gynecologist is easy. 

 

Simply call us directly or fill out our ‘Book my Appointment’ form.  It would ask you just four basic questions such as ‘Your name’, ‘Contact’, ‘Disease name’, and ‘City’. Just fill them and click ‘submit’. Our medical coordinators will call you shortly and help you speak to a doctor of your choice.

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