Molar Pregnancy

A molar pregnancy is a rare complication of pregnancy in which cells (trophoblasts) which feed the embryo and develop into placenta grow abnormally into a mass or tumor.

Molar pregnancy is of two types, Partial molar pregnancy and complete molar pregnancy. In a partial molar pregnancy, both placenta as well as the embryo are abnormal. In a complete molar pregnancy, the placenta is abnormal and there is no embryo.

What are the causes?
  • The major risk factor is maternal age. Women above 35 and below 20 are more at risk of having molar pregnancy.
  • If you have past personal history of molar pregnancy, then your risk of having a repeat molar pregnancy is 10%.
What are the symptoms?

Signs and symptoms of molar pregnancy do not appear immediately and the pregnancy may seem normal.  Overtime, signs and symptoms start to develop which are,

  • Vaginal bleeding during pregnancy.
  • Brownish vaginal discharge.
  • Severe nausea and vomiting
  • Passage of grape like tissue
  • Pelvic pressure or pain
  • Abnormally enlarged uterus for the stage of pregnancy
  • High blood pressure duriing pregnancy
  • Ovarian cysts duirng pregnancy
  • Anemia
  • Thyroid abnormalities
What tests will be required for diagnosis?
  • Utrasound – an ultrasound can detect molar pregnancy as early as eight weeks. It is done to check the embryo, amniotic fluid and placenta.  Ultrasound of molar pregnancy will show no embryo, no amniotic fluid and a thick placenta almost filling the entire uterus.
  • Blood test – human chorionic gonadotropin (HCG) is a pregnancy hormone. In molar pregnancy the level of HCG in blood is very high than in normal pregnancy, however, some women with molar pregnancy may have normal HCG.
What are the treatment options available?

A molar pregnancy is an abnormal pregnancy and must be removed surgically.

  • Dilation and curettage (D&C): During this procedure, the cervix is expanded and the product of conception is suctioned out using a vacuum device.  This is an outpatient procedure and requires local or general anaesthesia depending on the patient’s preference.
  • Hysterectomy: Surgical removal of uterus is known as hysterectomy. This procedure is only done when there is increased risk of gestational trophoblastic neoplasia (GTN) and the woman does not wish to be pregnant again.