Summary about Disease
A molar pregnancy, also known as hydatidiform mole, is a rare complication of pregnancy characterized by abnormal growth of trophoblasts, the cells that normally develop into the placenta. There are two types: complete molar pregnancy, where there is no fetal tissue, and partial molar pregnancy, where there may be some fetal tissue but it is not viable. It is considered a type of gestational trophoblastic disease (GTD).
Symptoms
Symptoms of molar pregnancy can mimic a normal pregnancy initially, but may progress to include:
Vaginal bleeding, often dark brown to bright red
Severe nausea and vomiting
Pelvic pain or pressure
Rapid uterine enlargement
High blood pressure
Pre-eclampsia before 20 weeks of gestation
Passing of grape-like cysts from the vagina
Hyperthyroidism symptoms (rare)
Causes
A molar pregnancy is caused by a genetic error during fertilization.
Complete molar pregnancy: Occurs when an egg containing no DNA is fertilized by one or two sperm. The chromosomes from the sperm duplicate, resulting in a set of paternal chromosomes only.
Partial molar pregnancy: Occurs when a normal egg is fertilized by two sperm or by a sperm that duplicates its chromosomes. This results in 69 chromosomes instead of the normal 46.
Medicine Used
4. Medicine used Molar pregnancies are not treated with medicines to sustain them. The primary treatment involves removing the molar tissue, usually by dilation and curettage (D&C). In some cases, if the woman does not desire future pregnancies, a hysterectomy might be considered. Following removal, monitoring of hCG (human chorionic gonadotropin) levels is crucial. If hCG levels remain high or rise, chemotherapy, typically with methotrexate or actinomycin-D, may be necessary to eliminate any remaining trophoblastic tissue.
Is Communicable
Molar pregnancy is not communicable. It is a genetic error related to fertilization and not an infectious disease.
Precautions
There are no specific precautions to prevent a molar pregnancy, as it is a result of random genetic errors during fertilization. However, women who have had a molar pregnancy are advised to wait a specified period (usually 6-12 months) after hCG levels return to normal before attempting another pregnancy.
How long does an outbreak last?
Molar pregnancy isn't an outbreak. The abnormal tissue must be removed, usually by D&C. Follow-up is needed for monitoring.
How is it diagnosed?
Molar pregnancy is typically diagnosed through:
Ultrasound: A transvaginal ultrasound can reveal the characteristic appearance of a molar pregnancy, such as a "snowstorm" pattern in complete moles or a fetus with severe abnormalities in partial moles.
hCG Measurement: High levels of hCG (human chorionic gonadotropin) in the blood are a strong indicator.
Pathology: Examination of the tissue removed during dilation and curettage confirms the diagnosis.
Timeline of Symptoms
Early Pregnancy: Symptoms often mimic a normal pregnancy initially (missed period, positive pregnancy test).
6-16 weeks: Vaginal bleeding, severe nausea, rapid uterine enlargement, and other symptoms start to appear.
Diagnosis: Typically made between 8 and 16 weeks of gestation based on ultrasound and hCG levels.
Treatment: D&C is performed soon after diagnosis.
Follow-up: hCG levels monitored regularly for 6-12 months to detect persistent GTD.
Important Considerations
Follow-up is crucial: Regular monitoring of hCG levels is essential to detect persistent gestational trophoblastic disease (GTD) or choriocarcinoma, a rare but serious cancerous complication.
Contraception: Reliable contraception is recommended during the follow-up period.
Future pregnancies: Women who have had a molar pregnancy have a slightly increased risk of another molar pregnancy. Obstetricians should be informed of the history in future pregnancies.
Emotional support: A molar pregnancy can be emotionally distressing. Support groups and counseling can be helpful.