As an egg gets fertilized by a sperm, it leads to the development of new tissues that further form the placenta and the fetus. However, when the tissue that is meant to form the placenta takes on abnormal growth, and threatens to form a tumor that might spread outside the uterus or womb, the condition is known as a molar pregnancy or gestational trophoblastic disease.
A majority of molar pregnancies happen to be non-cancerous growths that remain confined within the uterus. In such a mole, the abnormal placental tissue appears like a cluster of grapes and has tissue clusters that swell up with fluid and villi. In the rare case that a fetus develops together with a hydatidiform mole, it will have a lot of malformations and will not be delivered as a living baby.
On the whole, the tissues formed in such a pregnancy can develop into a form of cancer known as choriocarcinoma. Believe it or not, a majority of choriocarnimas are formed during molar pregnancies, with the rest forming during aborted pregnancies, tubal pregnancies, miscarriages and even healthy pregnancies.
7 Symptoms of molar pregnancies
Most of the symptoms of molar pregnancies are similar to those of a miscarriage. For this reason, many women who have a molar pregnancy continue to believe that they have had a miscarriage. From what is known, hydatidiform moles tend to exaggerate the regular symptoms of pregnancy. However, choriocarcinomas and invasive moles may trigger symptoms both during and/or after pregnancy. On the other hand, symptoms of a hydatidiform mole may develop and continue even after it is removed.
Now, there are many different symptoms of molar pregnancies, but amongst them all, the most common is that of vaginal bleeding that may trigger between the 6th and 16th week of pregnancy. Another common symptom of a molar pregnancy is that of bleeding that continues for a long time even after the baby is delivered. It is also common for small amount of blood to expel from the vagina in the form of a watery brown discharge. A woman who has a molar pregnancy may even pass pieces of tissue that have a grapelike appearance via the vagina. However, this symptom is not all that common.
You need to bear in mind the fact that most vaginal bleeding that occurs during or after pregnancy isn’t typically associated with molar pregnancies. But in either case, it is necessary for you to report any bleeding that occurs at any time during your pregnancy and get in touch with your health care professional right away. Other symptoms that can be caused by a mole or a choriocarcinoma are inclusive of:
- Severe bouts of vomiting during pregnancy
- Severe abdominal swelling that is triggered by the growing uterus – the uterus in such a pregnancy grows more rapidly than expected in the first trimester
- Excessive fatigue that is caused by anemia triggered by heavy bleeding
- Shortness of breath
- Vaginal discharge
- Pelvic cramping
- Sudden unbearable abdominal pain triggered by internal bleeding
There happen to be several different causes of all these symptoms. Most importantly, a majority of these are associated with normal pregnancies, so just having any of these symptoms in no way means you have a molar pregnancy.
6 Diagnosis of a molar pregnancy
Based on the symptoms that you experience during pregnancy or following pregnancy, it is possible for doctors to suspect a molar pregnancy. An abnormally large uterus is yet another reason for doctors to suspect molar pregnancies. Another reason for your doctor to suspect a molar pregnancy includes having an extremely high level of HCG or Human Chorionic Gonagotropin in the body. The levels of this hormone found in the bound are measure in all routine pregnancy tests. However, just having high levels of HCG doesn’t necessarily mean that you have a molar pregnancy considering that not all molar pregnancies have this.
Molar pregnancies are typically diagnosed during an ultrasound of the pelvis used to acquire images of the contents within the uterus. In case a molar pregnancy is diagnosed or suspected, your doctor will perform further tests so that the type of mole can be determined. Your doctor will also perform tests to determine whether the mole will spread beyond the uterus. The tests may include X-rays and CT scans or MRI scans of the pelvis, chest, brain and abdomen. If need be, your doctor may also order additional blood tests. Once the diagnosis is complete and a molar pregnancy is confirmed, the molar tissue will be diagnosed under a microscope by a pathologist to further verify the diagnosis.
Typically, molar pregnancies tend to present vaginal bleeding that is triggered between the fourth and the fifth month of the pregnancy. You may have enlarged ovaries together with a larger than expected uterus. Women who have molar pregnancies additionally suffer from hyperemesis or severe bouts of vomiting and nausea (more than usual). It is also possible for women to have increased blood pressure together with protein found in the urine. For the purpose of diagnosing a molar pregnancy, your doctor may also check the levels of hCG or human chorionic gonadotropin – if you have a molar pregnancy, there is a good chance that their level will be ridiculously high.
On the whole, the final diagnosis of a molar pregnancy is made through an ultrasound with a histopathological examination. In the sonogram, the mole will look like a cluster of grapes and that is what will confirm the onset of the mole.
5 How long will it last?
The treatment of a molar pregnancy can take up a bit of time ranging from weeks to months. The entire procedure, to be honest, can get rather overwhelming due to the amount of time that it takes. The worst part is that once the mole has been treated, it will be necessary for you to continually have blood tests and checkups. These typically tend to last anywhere between one and two years. All of these repeated tests are performed so as to make sure that the mole has been properly treated and that the problem has not returned.
Molar pregnancies are rather complicated to be honest and their treatment does not come easy. Even after the treatment is completed, it is necessary for you to have regular checkups and blood work done so as to ensure that there aren’t any complications. Also, it is highly recommended for you to refrain from getting pregnant again till the time that your hCG hormone monitoring procedure has been completed after the treatment of a molar pregnancy. This will probably be done in a few months, but in certain cases, it has the potential to take up to a full year too so you need to be careful. If you are unsure about things, don’t make assumptions about things and get in touch with your health care provider right away.
A majority of women out there who suffer from persistent trophoblastic disease receive chemotherapy based treatment for their condition. In such a case, their periods are expected to resume six months after the completion of the treatment. However, as a means of preventing the onset of pregnancy related complications, it is best for couples to refrain from trying to conceive a baby for another 12 months or so once the chemotherapy treatment comes to an end. To do so, you may use any contraception method that you deem best and may even choose to remain on the pill for the said purpose. The only reason for this is to make sure that the mole has been properly treated and that there won’t be any other complications in further pregnancies.
4 Ways to prevent molar pregnancies
Believe it or not, but any woman out there who becomes pregnant is at the rise of developing uncommon pregnancy conditions including molar pregnancies. However, when it comes to molar pregnancies, the risk is somewhat higher in pregnant women who are either younger than 20, or above the 40 year mark. But the good part is that there are plenty of ways for you to prevent the onset of a molar pregnancy. Amongst them all, the best is that of receiving adequate routine prenatal care by a highly qualified doctor. The reason this is so is because doing so will make it possible for you to have any problems that might arise identified in their most initial stages. With early detection, their treatment will also be easily possible as compared to if they get identified in their later stages.
Now, those who have previously had a molar pregnancy must get in touch with their health care provider before trying to conceive again. If this is the case for you, then there is a good chance that you will be asked to wait six months to a year before trying to conceive again. While you are at it, all of your subsequent pregnancies are going to be closely monitored. Your doctor will perform regular ultrasounds all through your pregnancy so as to remain assured of normal development.
The one thing that you need to bear in mind is that your chances of having a repeat molar pregnancy may rise significantly if you have already had one. As unfortunate as it may sound, having a molar pregnancy once has the potential to increase your chances of having another in the future by about 1-2%. The worst part is that considering that the causes of a molar pregnancy remain unknown to us as of yet, there aren’t any definitive preventive measures that you can take for it. But in case you have already had a molar pregnancy, you can reduce your chances of having another by not getting pregnant at least for another year or so. During this period of time, your uterus will be able to get rid of any molar or abnormal tissue in it, and then your body will be able to start fresh.
3 Treatment of a molar pregnancy
As dangerous as molar pregnancies are, their adequate and timely treatment is extremely important. To begin with, treatment plans for such pregnancies are formulated based upon the results of diagnostic tests that are performed. There are plenty of treatment options out there and include things like surgery for the removal of the tumor. However, if you have a rather aggressive form of molar pregnancy, there is a good chance that you will have to seek radiation therapy and/or chemotherapy. However, it is common for about 85% of hydatidiform moles to be treated without having to seek chemotherapy. Although just minor surgery is required in a majority of cases for the treatment of a molar pregnancy, around 10 to 15 out of 100 women who have complete molar pregnancies need to undergo chemotherapy. However, the stats are rather low for women with partial molar pregnancies. In such a case, only about 1 in 100 women require chemotherapy for treatment purposes.
Apart from that, there are several treatment options available for women who have molar pregnancies. These are inclusive of:
- Hysterectomy or removal of the uterus – Used rather rarely, this procedure is meant for the treatment of hydatidiform moles. However, it is particularly used in cases where the woman does not wish to have any more children.
- Dilation and curettage (D and C) - This surgical procedure is meant to assist in the removal of non-cancerous hydatidiform moles. In the procedure, the opening of the cervix is dilated, thereby making it possible for the inside uterus lining to be scraped clean with the help of suction and a spoonlike instrument designed particularly for this purpose.
- Radiation treatment – In this treatment, high strength X-ray beams are used for the destruction of cancer cells in case the tumor has spread to the point that it reaches the brain.
- Chemotherapy with a single drug – This particular treatment uses medication that is toxic to the molar tissue. It is particularly meant to treat molar pregnancy tumors that suggest a good prognosis.
- Chemotherapy with multiple drugs – For this treatment, several medication are used and all of them are toxic to the molar tissue. This treatment is best used for the treatment of invasive tumors that have poor prognosis.
2 Complications – When you should get in touch with a professional
If you are pregnant, it is necessary for you to acquire proper prenatal care particularly in the first trimester so that any complications can be ruled out in time. If you have severe vomiting, bleeding, or severe abdominal pain, make sure that you get in touch with your health care provider right away so that an adequate evaluation can be made.
The thing with molar pregnancies is that these can lead to several complications. One of the most common complications that arise after a molar pregnancy has been treated is that molar tissue may remain and continue to grow in the uterus. Such a situation is called persistent gestational trophoblastic disease or GTD. The worst part is that the statistics for this complication are rather high and it occurs in nearly 1 out of every 5 women who experience a molar pregnancy. Most importantly, this complication tends to arise typically in women who have a complete mole instead of a partial mole. Considering how common this particular complication is, it is necessary for women who have been treated for a molar pregnancy to be regularly checked and evaluated so that the issue can be resolved on an as soon as possible basis.
Now, there are many different symptoms of a persistent GTD. However, the most common amidst them all is that of having high levels of human chorionic gonadotropin or HCG in the body even after the molar pregnancy has been treated. This is basically a pregnancy related hormone, which goes down once the pregnancy is over. However, in a case of persistent GTD, its levels continue to remain high in the body even after the molar pregnancy has been treated and removed from the body. Another complication that is known to arise in certain cases along with persistent GTD is that of an invasive mole penetrating deep into the middle layer of the uterine wall. This causes a lot of vaginal bleeding. But there is good news – even though persistent GTD is rather common, its treatment is also easily possible through chemotherapy. However, if you wish, you may also opt for hysterectomy.
1 Is treatment successful?
As long as proper treatment is provided to women, it is possible for all hydatidiform moles to be cured. Along with it, a majority of cases of aggressive molar tumors can be cured as well through appropriate treatment. Even in cases where women have tumors whose features categorize them as having extremely poor prognosis, it is possible for about 80% to 90% of cases can be cured by using a combination of surgery and chemotherapy.
In order for the treatment to be successful, it is necessary for you to be evaluated on a regular basis once you have been treated for a molar pregnancy. This basically plays a vital role in terms of avoiding any and all complications that might arise as a result of the pregnancy. Apart from that, it is highly recommended for women to refrain from trying to conceive for about a year once their molar pregnancy has been treated. This also assists in ensuring that the levels on HCG in the body remain at zero, which signals that further treatment is not required and that there aren’t any complications to see to. However, considering that women who have already had a molar pregnancy are at higher risk of having another, it is best to get regular check-ups so that any issues that might arise are promptly diagnosed and treated. But the one thing that you can be assured of is that it is 100% possible for you to have a healthy and normal pregnancy once you are treated for a molar pregnancy.
From what we know through statistics, just about all women who experience a molar pregnancy can be cured. This is because doctors and health care specialists remove every bit of the abnormal molar tissue by performing surgery. In a majority of cases, women don’t typically require any additional treatment. However, in case a complication arises and a piece of the abnormal cells remains in the body or spreads in the womb, it is necessary for chemotherapy to be performed so that the remaining abnormal tissue can be treated – and yes, a majority of such cases are curable through a combination of surgery and chemotherapy.