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.
A molar pregnancy can happen because of multiple reasons including-
Partial Mole Pregnancy
Complete Mole Pregnancy
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
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.
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.
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-
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
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.
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.
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.
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:
Consult your gynecologist as soon as you experience :
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:
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-
Cost: The medical management of molar pregnancy typically costs between Rs. 2000 to Rs. 3000 in India.
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.
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.
The removal of molar pregnancy is both necessary and safe. The risks of complications are standard and mild, and the surgery holds no long-term side effects.
Mrs. J (32 years, Hyderabad) approached us with complaints of sudden and severe vaginal bleeding along with acute pressure at her pelvis. She was 9 weeks pregnant and feared a case of repeated molar pregnancy.
Sensing the urgency of the treatment, we fixed Mrs. J the same-day clinical appointment with Dr. Juhul Patel. Unfortunately, the ultrasound and HCG report confirmed 9 weeks of complete molar pregnancy.
Sensing the fear and discomfort, Dr. Patel comforted Mrs. J. He guided her on the condition, why it happens, the need for urgent treatment, and her treatment options. Soon, the D&C treatment was scheduled for the next day.
The procedure turned successful with complete removal of molar pregnancy. However, the patient’s dropping blood pressure suggested hemorrhagic anemia which necessitated a blood transfusion. For the same, Mrs. J was transfused with 2 units of blood. Later, as her vitals became normal, she was transferred to the general ward. Once Mrs. J felt better, Dr. Patel guided her on her recovery and diet. She was discharged the next day healthy and sound.
Follow-up after 5 days suggested a substantial recovery, whereafter, Dr. Patel guided the couple on post-care, future pregnancies, and a guideline of further prevention to avoid a repeat case of molar pregnancy.
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.
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