Molar Pregnancy
June 11, 2008
A molar pregnancy refers to a pregnancy that is a type of gestational trophoblastic disease. It can refer to either a complete or a partial mole.
Throughout the United States and Europe the incidence is about 1/1000 and 1/2000 pregnancies. Although it is much more common in areas such as Southeast Asia and Mexico.
What is a molar pregnancy?
A molar pregnancy is a mass of tissue (hydatidiform mole) that forms an abnormal placenta inside the uterus. It starts from two or three sets of the father’s chromosomes, with none from the mother. Even though it is not an embryo, a mole triggers symptoms of pregnancy. About 1 out of 1,000 women with early pregnancy symptoms has a molar pregnancy.
There are two types of molar pregnancy: complete and partial.
- Complete molar pregnancy. In place of a normal placenta and embryo, the hydatidiform mole is abnormal placental tissue that grows into a grapelike cluster that can fill the uterus.
- Partial molar pregnancy. The placenta grows abnormally into molar tissue. Any fetal tissue that develops is likely to have severe defects.
Symptoms of molar pregnancy
- Vaginal spotting or bleeding
- Nausea and vomiting
- Develop rare complications like thyroid disease
- Early preeclampsia (high blood pressure)
- Increased hCG levels
- No fetal movement or heart tone detected
Causes of molar pregnancy
· An abnormal egg with no genetic information is fertilized by a sperm. The sperm’s chromosomes duplicate and develop into a complete mole.
· A normal egg is fertilized by two sperm. This cell mass is most likely to develop into a partial mole.
Factors that may increase your risk of having a molar pregnancy include:
· Age. Risk for complete molar pregnancy steadily increases after age 35.
· History of molar pregnancy, particularly if you’ve had two or more.
· History of miscarriage.
· A diet low in carotene (a form of vitamin A). Women with low carotene or vitamin A intake have a higher rate of complete molar pregnancy.
Treatment for recurrent molar pregnancy
When the HCG levels drop then increase again it means that the molar pregnancy has grown from microscopic cells in the wall of the uterus to larger cells. These cells can act like a cancer, and metastasize (spread) to other organs, like the lungs, brain, bones, and vagina. Treatment for recurrent molar pregnancy, called gestational trophoblastic neoplasia, or GTN, in medical terms, usually consists of a chemotherapy medication called methotrexate.
Fortunately, methotrexate is a pretty “easy” chemotherapy on the system, and can be given as an intramuscular shot. Sometimes only 1 shot is necessary. In other cases, multiple shots, or even the addition of other medications, is necessary. Also, when GTN is suspected, the patient usually gets a CT scan of the brain, lungs, and abdomen, and a battery of blood tests. Again, weekly HCG tests are obtained until they fall to zero, then careful follow-up is undertaken for a year. Patients can expect an almost 100% cure rate using chemotherapy.
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