What does molar pregnancy mean? Molar pregnancies originate from improper fertilization and, if left untreated, can cause major health problems. Below is information regarding this uncommon pregnancy problem.
The majority of pregnancies are healthy and develop normally. Yet, approximately one in one thousand pregnancies are complicated by a disorder known as a hydatidiform mole. Molar pregnancies are generated by the unbalanced combination of genetic material from the egg and sperm. They rarely result in a viable pregnancy.
Thankfully, molar pregnancies seldom affect subsequent pregnancies. Here are the causes, risk factors, symptoms, and conventional treatments for a molar pregnancy.
What Constitutes a Molar Pregnancy?
According to Sasha Andrews, M.D., a maternal-fetal medicine specialist at Obstetrix of Colorado, part of Pediatrix Medical Group, the phenomena that cause a molar pregnancy occurs at the very beginning of gestation. Molar pregnancies result from the improper combination of genetic material from the egg and sperm. This results in the unusual development of the cells that normally comprise the placenta. Complete and partial pregnancies are the two most common forms of molar pregnancies.
- In a full molar pregnancy, a dysfunctional placenta develops without an embryo.
- A defective placenta and an embryo that cannot survive develop in a partly molar pregnancy.
When a molar pregnancy advances, the placenta forms a bulk that assumes control. This lump or tumor is known as a hydatidiform mole, thus the name molar pregnancy.
Usually, molar pregnancies resolve entirely following treatment, but occasionally they become invasive or malignant. Thus, molar pregnancies must be completely removed from the body, and blood hCG levels must be monitored. During this follow-up time, it is essential to note any pregnancies, as a new pregnancy could make detecting the development of cancer difficult.
Fortunately, molar pregnancies are uncommon, occurring in approximately 1 out of every 1,000 pregnancies.
Why Does a Molar Pregnancy Occur?
Molar pregnancies are caused by complications that arise when the sperm and egg interact. Dr. Andrews explains that both partial and complete molar pregnancies are produced by improper fertilization, which results in an imbalance of genetic material from the egg and sperm.
In full molar pregnancies, one or two sperm fertilize an unfertilized egg, transmitting only paternal genetic material. Although there is maternal genetic material present, two sperm fertilize the egg in a partial molar pregnancy, which results in an abnormally high number of paternal chromosomes.
Variables Associated with a Molar Pregnancy
Even though molar pregnancies are unusual, anyone might experience one. Dr. Andrews notes that certain individuals may be more likely to experience this kind of pregnancy. Younger women (less than 20 years) and older women (over 35 years) are at a greater risk. Dr. Andrews warns that having a previous molar pregnancy increases your likelihood of having another one. According to March of Dimes, the probability of a subsequent molar pregnancy is between 1 and 2%.
Symptoms of a Molar Pregnancy
Dr. Adi Katz, director of gynecology at Lenox Hill Hospital, notes that early symptoms of molar pregnancy may match those of any pregnancy, such as missing menstruation. As time passes, you may develop more, more worrisome symptoms. Dr. Katz describes these as acute nausea and vomiting, vaginal bleeding, lower abdominal pain, or pressure from the uterus. “The uterus may be larger than anticipated,” she explains. Several of these kinds of pregnancy symptoms, including severe nausea and vomiting, are caused by abnormally high levels of the pregnancy hormone hCG.
Occasionally, individuals with molar pregnancies suffer hypertension or preeclamptic symptoms, such as swelling of the limbs. In addition to thyroid disorders (such as hyperthyroidism), grape-like cysts may develop in the vagina.
Dr. Katz warns that certain symptoms of molar pregnancy necessitate immediate medical attention. One of these is anemia from excessive vaginal bleeding. Dr. Katz notes that extreme nausea and vomiting accompanied by an inability to eat or drink can lead to serious dehydration.
Diagnosing a Molar Pregnancy
Your healthcare practitioner may suspect a molar pregnancy if you experience abnormal bleeding or other worrying symptoms, if your hCG levels are greater than expected, or if your first-trimester ultrasound is abnormal. Occasionally, partial molar pregnancies are detected with pathology after submitting tissue from a first trimester miscarriage that appears to be normal.
Molar Pregnancy Procedure
Some people will spontaneously miscarry their molar pregnancy. When this occurs, you may experience bleeding and the discharge of grape-like cysts. A partial kind of this pregnancy miscarriage may be indistinguishable from a typical first-trimester miscarriage. Typically, molar pregnancies must be medically removed, typically with a dilatation and curettage (D&C) treatment, which employs a suctioning device to remove tissue from the uterus.
According to Dr. Katz, a “wait and see” approach to molar pregnancies is not prudent. “Leaving it untreated is dangerous,” she explains. Dr. Katz explains that in addition to the D&C procedure, your hCG levels will need to be monitored for several weeks or months until there is no longer any pregnancy hormone in your body. This indicates that there are no traces of the molar pregnancy remaining.
After this kind of pregnancy, the majority of healthcare professionals recommend waiting at least 6 to 12 months before becoming pregnant again. This guarantees that no aberrant tissue remains and reduces the likelihood of a subsequent molar pregnancy.
Problems Potential to a Molar Pregnancy
If a molar pregnancy is not treated properly and quickly, it may cause both short-term and long-term problems. Dr. Andrews states that “immediate consequences of molar pregnancies can include anemia from vaginal bleeding and hyperemesis gravidarum” (a severe form of morning sickness). High levels of hCG can also result in improper thyroid function and ovarian theca lutein cysts. Preeclampsia may seldom develop, according to Dr. Andrews.
Even after therapy, in some individuals, tissue from this kind of pregnancy stays in the uterus and develops into gestational trophoblastic neoplasia (GTN). This occurs in 1–5% of partial molar pregnancies and 15-20% of total molar pregnancies. Typically, GTN is treated with chemotherapeutic agents and/or surgery. Even less frequently, molar tissue develops choriocarcinoma, a type of cancer that may require chemotherapy and other cancer-fighting medications.
It can be frightening to hear of molar pregnancies and associated complications. The majority of women who experience molar pregnancies do not develop long-term complications and go on to have healthy pregnancies in the future, especially if they receive effective treatment. Don’t hesitate to contact your OB-GYN or midwife if you have questions regarding molar pregnancies or suspect you may be experiencing one.
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