Overview
A molar pregnancy occurs in about one in six hundred pregnancies. At the time of fertilization, unfortunately, the genetics go a little bit wrong. During a normal pregnancy, a woman’s egg has twenty-three chromosomes or bits of genetic material, and dad’s sperm has the same twenty-three chromosomes are bits of genetic material. When conception occurs these two joins together and forms a cell with forty-six chromosomes of bits of genetic material from which a baby develops. Unfortunately, during a molar pregnancy, genetics goes a little bit wrong.
In a complete molar pregnancy, the genetic material from Mom’s egg is absent. Fertilization occurs and dad’s sperm fertilizes the egg but unfortunately, there are only twenty-three chromosomes are bits of genetic material present. Nature knows that there should be forty-six chromosomes in the cell.
So, dad’s sperm genetic material is duplicated. It is due to there is no input from mom into this pregnancy. unfortunately, a bay does not develop but dad’s genetics code for the development of the placenta or after birth. So, unfortunately an abnormal percenter develops inside in the uterus in a complete motor pregnancy and that’s what leads to the complete mode of pregnancy.
In a partial molar pregnancy, there is genetic material from mom but an extra sperm fertilizes the egg. So instead of forty-six chromosomes the new conception ends up with sixty-nine chromosomes with the extra set from the dead. Unfortunately, this again is an abnormal conception there may be early fatal or baby development but usually these end up as a miscarriage and when the genetic and tissue is assessed in the laboratory a diagnosis of a part and molar pregnancy occurs.
What are the indicators of molar pregnancy?
Women may mistake molar pregnancy and think like it is a normal pregnancy. Due to this reason, it is really important to identify the symptoms of molar pregnancy.
Pain in the pelvic, vaginal passage of grapelike cysts, nausea, overactive thyroid, vomiting, Anaemia, rapid uterine growth, high blood pressure, ovarian cysts, and preeclampsia are the signs and symptoms of molar pregnancy.
It is really important for the people who are suffering from the above symptoms to consult a health professional.
What are the causes of molar pregnancy?
The main cause of a molar pregnancy is an abnormally fertilized egg develops inside in the uterus. As there twenty-three pairs of chromosomes contained by the human cells and both should come from the mother and father. An error occurs in the uterus leads to the molar pregnancy.
What are the risk factors of molar pregnancy?
There are a number of well-established risk factors developing the condition. The following are the risk factors contributing to the cause of molar pregnancy. These risk factors include
- Maternal age
- Previous history of molar pregnancy
Maternal age
Women who are thirty-five years of age have an increased risk of getting diagnosed with molar pregnancy.
Previous history of molar pregnancy
If a woman had already diagnosed with molar pregnancy in the past, then she is more likely to develop this condition. A repeated molar pregnancy occurs one in every hundred women.
What are the complications of molar pregnancy?
There are a variety of complications a woman can experience after molar pregnancy has been removed. A tissue in the uterus will continue to grow even after the removal of molar pregnancy. Fifteen to twenty percent of the women experience this and it is known as persistent gestational trophoblastic neoplasia (GTN).
HCG is one of the common signs in the woman with persistent gestational trophoblastic neoplasia (GTN). HCG is a pregnancy hormone and it can cause vaginal bleeding. People with persistent GTN may require some extra treatment in the form of chemotherapy to help cure these cells.
Gestational trophoblastic neoplasia spreads to the other organs of the body but this is very rare in partial molar pregnancies. Multiple cancer drugs are used in the prevention of choriocarcinoma.
How is molar pregnancy diagnosed?
A molar pregnancy is diagnosed in the laboratory by assessment of the tissue that has been removed at the time of miscarriage. In a complete and partial molar pregnancy not all of the tissue may have disappeared at the time of treatment of the miscarriage. It is mandatory to follow up every patient with a weekly blood test to make sure that the disease has gone away.
This blood test measures HCG (Human Chorionic gonadotropin) in the woman’s blood to make sure that these cells have disappeared. In about eighty-five percent of cases in a complete molar pregnancy will happen spontaneously and the blood tests will go down to normal very often taking about eight or twelve weeks. In a partial molar pregnancy very often these blood tests return to normal much more quickly at about four to six weeks.
In a complete molar pregnancy, blood tests may return to normal but there is still a chance that some of these cells could redevelop in the first six months afterward and therefore once the blood tests have come down to normal your physician will follow them up for about six months afterward. In a partial molar pregnancy, the risk of the cells redeveloping is so small that once the HCG results have come to normal. Again, your doctor will conduct one further test a month later and if that is normal then follow up will complete.
In some patients mostly those with a complete molar pregnancy about fifteen percent of the time that says do not go away by themselves and the HCG results either return to normal and go back up or don’t return to normal at all. Those patients may require some extra treatment in the form of chemotherapy to help cure these cells and this is very rare in partial molar pregnancies.
What are the treatment options available for molar pregnancy?
There are treatments for this which can include surgery, prescription medications, and other forms of treatment. These treatment options include
- Dilation and curettage (D&C)
- Hysterectomy
- HCG monitoring
- Chemotherapy medications
Let’s discuss the above treatment options in detail:
Dilation and Curettage (D&C)
The main objective of this treatment is to remove the molar tissue from the uterus, and this process is called dilation and curettage (D&C). Your physician will remove the tissue with the help of a vacuum device. Before that, a speculum will be inserted into your vagina to see your cervix.
Hysterectomy
Hysterectomy is a surgery that is used to remove the entire womb. You will never have the chance of getting pregnant again if you choose this option. It is not a common treatment option for women with molar pregnancy.
HCG monitoring
Your physician measures HCG (Human Chorionic gonadotropin) in the woman’s blood to make sure that these molar tissues have disappeared. Those patients may require some extra treatment if the levels of HCG don’t return to normal.
Chemotherapy medications
If the cancerous cells do not go away by themselves after the removal of molar tissue from the uterus, then your physician may recommend additional treatment in the form of chemotherapy to help cure these dangerous cells. It has been observed in research that ninety percent of the cancers due to molar pregnancy is treatable.
Coping and support
Women who lost the chance to give birth to a child due to the molar pregnancy may feel extremely sad after the removal of the molar tissue from the uterus and those people need to get support. If you don’t have anyone to call for in your need, then it is advised to seek a counselor or pregnancy care provider who listens to you.
Conclusion
Molar pregnancies are not common but it can put you in a sad mood. Due to this reason, it is advised to consult your doctor or a therapist immediately if you are experiencing any of the symptoms described above. Your doctor should evaluate you for other possible causes of your symptoms before treating the existing condition. Together, you and your doctor can determine the best way to manage your symptoms because it is important to get an accurate diagnosis and prompt treatment.
References
- https://www.gynecologiconcology-online.net/article/S0090-8258(16)30988-X/fulltext
- https://www.sciencedirect.com/science/article/pii/S235257891730108X
- https://pubmed.ncbi.nlm.nih.gov/26777992/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1809221/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901474/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483742/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039626/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604441/
Image Source: https://sites.google.com/site/casesonography/obstetrics/molar-pregnancy
Sirisha B