Molar Pregnancy Treatment by Best Gynecologist

Diagnosis and Treatment for Molar Pregnancy

Diagnosis- Molar Pregnancy

Ideally, a molar pregnancy is diagnosed during regular pregnancy check-ups. But, if the patient experiences symptoms indicating a molar pregnancy, the doctor might suggest any of the following tests to confirm the condition.

• Blood tests- This test is performed to assess the level of hCG, which is a pregnancy hormone. hCG level increases in the case of molar pregnancy as compared to normal pregnancy. 
• Transvaginal ultrasound- It is performed to produce a detailed picture of your uterus. It scans the presence of the tissue inside the uterus. It also helps in understanding the presence of cysts in the uterus. 
• Urine test- It is performed to check the colour and composition of urine. Urine tests also help in understanding the level of hCG. A high hCG level in urine indicates molar pregnancy tissue in your body. 

If your healthcare provider detects a molar pregnancy, he/she may also check for other medical problems.

Treatments- Molar Pregnancy

Treatment of molar pregnancy is possible through medicines and surgery. Although medical termination is not commonly preferred because it requires continuous monitoring, repeated follow-ups, and longer treatment duration. 

However, if the molar pregnancy is detected earlier in the cycle without unstable bleeding, the patient favours medical management.   

Medication- Methotrexate medicine is generally used to treat molar pregnancy. The medicine is directly given to the patient through an injection in a single dose. Doctors monitor the hCG level before and after the procedure. You may need a second dose if the first dose fails to end the pregnancy. Ultrasound is performed to confirm the termination. 

Surgery- Molar pregnancy can be removed surgically through D&C procedure followed by a methotrexate injection. The surgery is performed under the influence of general anesthesia, hence it is completely painless. While performing the procedure, the doctor gives medicine for dilation of the cervix, which takes around 30-40 minutes. Once the cervix is dilated, the surgeon uses a curettage instrument to remove all the pregnancy tissue from the uterus. After that, the cervix contracts naturally, and the pregnancy is terminated without the need for any cuts or sutures.

Hysterectomy (uterus removal) – It is performed only when there is an increased risk of gestational trophoblastic neoplasia (GTN), and the female has no desire for future pregnancies. It can be performed through both open-cut incision and laparoscopy.

What precautions do you need to take after molar pregnancy treatment?

Here are some precautions that you need to take for at least 2 weeks to avoid any further complications.

• Avoid using tampons- Using tampons after the molar pregnancy surgery can potentially increase the risk of microbial infection.  
• Avoid using scented soaps- Scented soaps contain harsh chemicals that can be hard on your skin and can increase the risk of infection.
• Use Sanitary pads for post-surgical vaginal bleeding-  Sanitary pads prevent leakage of post-surgical vaginal bleeding and are safer than tampons or menstrual cups.

The possible long-term impact of molar pregnancy treatment

A woman’s mental and psychological health gets affected immensely after the end of any pregnancy including a molar pregnancy. The loss of pregnancy is a traumatic event that affects every woman mentally, physically and emotionally.

• Effect on mental health- Pregnancy loss can lead to emotional and mental distress, such as anxiety disorders, depression, and post-Traumatic Stress Disorder (PTSD). In some cases, the guilt of ending the pregnancy takes over heavily, and the woman isolates herself from friends and family.
• Effect on fertility-  Medical and surgical treatment of molar pregnancy usually doesn’t affect fertility. But in some cases where a hysterectomy is performed, the female can no longer carry a baby. Women who already have children are less concerned about their fertility than women without children. 

What are the complications associated with molar pregnancy treatment?

Certain risks and complications associated with molar pregnancy treatment are – 

Perforation of the uterus – Perforation of the uterus during curettage occurs when the uterus is large and boggy. If perforation is feared, the procedure should be completed under laparoscopic guidance.

Hemorrhage – Hemorrhage is the most frequent complication during the elimination of a molar pregnancy.

After the complete elimination, molar pregnancy tissue may remain and continue to grow in 15% to 20% of complete molar pregnancy. This is called persistent gestational trophoblastic neoplasia (GTN).