molar pregnancy

Although it's not common, affecting around 1 in 1.500 expectant mums, molar pregnancy is listed as one of the most important abnormal forms of pregnancy.

You may not have heard of it before but, even if you have, it's good to know its most common symptoms and how to have it treated, because it can lead to serious health problems. 

But first, let's start by answering a necessary question here: what is a molar pregnancy? Also called hydatidiform mole, it is the abnormal growth of the tissue that is supposed to form the embryo in the womb. It occurs when a fertilised egg develops into a mass of cysts, a benign tumor that looks like a cluster of grapes, but ends up causing pregnancy symptoms, which can make it go unnoticed for a few weeks.

 

Causes and types of molar pregnancy 

Molar pregnancy is caused by genetic problems during conception. In normal pregnancies, the egg that gets fertilised has 23 pairs of chromosomes, 23 from the mother and 23 from the father, that contain the DNA of our organism. But that's not how it happens in molar pregnancies, which can be divided into two types: 

  • Complete molar pregnancy: it takes place when the fertilised egg doesn't have any chromosomes from the mother, but two sets from the father. It usually results in a mass of cysts that can fill the uterus with no embryo, placental tissue or amniotic sac.

  • Partial molar pregnancy: it's the one characterised by a fertilised egg with chromosomes from the mother but a duplicated number from the father's, so the embryo is formed by 69 chromosomes and not 46, as it would occur under normal circumstances. In such a case, there's usually placental tissue and an embryo, but it's expected to have severe defects. The partial molar is often caused by two sperm fertilising a single egg.

 

What symptoms does it cause?

Molar pregnancy is a tricky condition, as it can mimic the normal pregnancy symptoms for several weeks before it's diagnosed. However, there are certain red flags that you should be on the lookout for, including the following molar pregnancy symptoms:

  • Bleeding from the vagina during the first trimester that can be red bright to dark brown.
  • Discomfort in the pelvic area that often feels like a pressure feeling.
  • Abdominal cramping and swelling.
  • Severe nausea and vomiting.
  • Passing tissue, cysts shaped like grapes, through the vagina.
  • Abnormal uterine growth, being larger than expected according to the stage of pregnancy.
  • High blood pressure.
  • Hyperthyroidism.
  • Preeclampsia that develops earlier than usual.

 

How can molar pregnancy be treated? 

Molar pregnancy can be diagnosed through a pelvic exam or pelvic ultrasound and a blood test that measures your pregnancy hormones.

Unfortunately, the pregnancy will need to be interrupted. If you happen to suffer from this abnormal condition, you'll have to undergo a surgical procedure known as Dilation and Curettage (D&C), through which you'll have the molar tissue removed from your uterus. The mass of cysts is suctioned by a hollow plastic tube inserted into the cervix and, once that part is over, the doctor uses a curette, a spoon-shaped device, to scrape the leftover tissue that may be attached to the uterine walls. 

If you rule out any possibility to become pregnant again, you could also have a hysterectomy, another operation that consists in removing your whole uterus to prevent abnormal tissue from growing back.

 

What are the risks for you? 

If the tests reveal that you have a molar pregnancy, you'll have to be treated right away, but that won't be all. Afterwards, you'll have regular blood tests over the next six to twelve months, in order to look for remaining molar tissue, which could be a sign of trophoblastic disease, the proliferation of more cells in the womb. Most times, these moles are benign and can rarely turn into cancer (choriocarcinoma), though almost all the women who have it get cured by following a chemotherapy treatment, especially if it hasn't spread beyond the womb. Once you are in remission, you can expect to be monitored regularly for about a year.

Molar pregnancy has been associated with diets low in protein and vitamin A, whose lack could affect the quality of your ovulation. Some studies support that having leafy green vegetables and fruits can reduce the risk of molar pregnancies.

 

Will I be able to get pregnant again?

Absolutely, because having a molar pregnancy doesn't have any impact on your fertility. However, you'll have to talk to your care provider before trying to conceive again. Keep in mind that after being treated for a molar pregnancy, you'll have to wait until your pregnancy hormone levels go back down to zero, so that your doctor can rule out the possibility of more abnormal tissue growing in your womb. 

You won't be at a higher risk of having another molar pregnancy (only a 1 to 2% chance) and other complications and defects either. It'll be a complete reset.

 

As you can see, a molar pregnancy can be scary, despite being treatable with positive prognosis. Indeed, there's an emotional component involved that can hit you badly. Just think about it this way: you have to deal with the loss of your baby and, at the same time, cope with an unusual condition that requires surgery to be fixed and regular follow-up appointments to prevent future complications. You may feel anxious and scared about your own health and reluctant to conceive again, so consider seeking counselling if you feel like you need it.