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What is a molar pregnancy and how to treat it

Madeline Kennedy , Business Insider US
 Nov 27, 2019, 04:19 PM
Researchers don't have a definite answer about whether dogs can sense pregnancy.
  • A molar pregnancy happens after fertilisation, when the tissue that normally becomes the placenta forms an abnormal growth, called a mole, instead.
  • Symptoms of molar pregnancy are similar to a miscarriage or ectopic pregnancy and include bleeding, pelvic pain, high blood pressure, and nausea.
  • To treat molar pregnancy, doctors will insert a device into your cervix and scrape away the molar tissue in a procedure called dilation and curettage.
  • This article was reviewed by Julia Simon, MD, who is an assistant professor with the Department of Obstetrics and Gynecology at UChicago Medicine.
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If you have a molar pregnancy, it is impossible for a fetus to survive. That's because, during fertilisation, something goes wrong that you can neither control or prevent.

Normally, after fertilisation, tissue develops that will eventually become the placenta. But for a molar pregnancy, that tissue forms an abnormal growth, called a mole, in the uterus, instead.

Without the placenta, there's no way to nourish the fetus, and a miscarriage will usually occur early on in the pregnancy.

Moles from a molar pregnancy can be detected at around eight or nine weeks into pregnancy. A doctor may order a test of your hCG, a pregnancy hormone that normally decreases over time but remains high in molar pregnancies. The doctor may also perform an ultrasound.

Complete and partial molar pregnancy

There are two types of molar pregnancy - complete and partial.

In a complete molar pregnancy, no placental tissue forms. In a partial molar pregnancy, some normal placental tissue - and sometimes fetal tissue - forms but not enough to sustain a healthy pregnancy.

In either case, the body reacts as if the abnormal tissue is an embryo and you may feel the symptoms of early pregnancy.

Signs and symptoms of molar pregnancy

Common symptoms include:

  • Vaginal bleeding
  • Pelvic pain
  • Severe nausea and vomiting
  • High blood pressure (in some cases)
  • Ovarian cysts (in some cases)

"Any woman with bleeding or pain in pregnancy should be evaluated by their doctor," says Staci Pollack, an OB-GYN at Montefiore Health System.

But these symptoms aren't unique to molar pregnancies and at first they can sometimes be mistaken for something else. "Women with molar pregnancies are often suspected of having a miscarriage or an ectopic pregnancy," Pollack says.

That's why doctors will follow up by reading your hCG levels and performing an ultrasound to identify the proper diagnosis. That way they can give you the right treatment.

Treatment often involves surgery

Usually, treatment for molar pregnancy is a surgical procedure called dilation and curettage (D&C). This is where doctors will insert a device through your cervix to reach your uterus and scrape the molar tissue away.

However, in rare cases, the molar tissue can return after a D&C and grow to form a type of tumor called gestational trophoblastic neoplasia (GTN.) GTN is generally treated with chemotherapy or a hysterectomy if needed.

Your risk of molar pregnancy is at least 1 in 1,000

A molar pregnancy occurs in about 1 in every 1,000 pregnancies. But if you've already had a molar pregnancy, then your risk of getting another one increases to about 1 in 100.

The age at which you become pregnant has a significant effect on your risk of molar pregnancy. A 2016 study published in Gynecologic Oncology found that adolescents under the age of 20 were seven times as likely to develop a complete molar pregnancy as people ages 20 to 40. And people over 40 were nearly twice as likely.

You may need to wait a year to get pregnant again

Unfortunately, there is no sure way to prevent a molar pregnancy. But if you have had a molar pregnancy in the past, your doctor will continue to monitor your hCG levels and may suggest that you wait a full year before trying to get pregnant again.

Yet, there is a good reason to be hopeful for future attempts. "Even if a woman has a molar pregnancy, this is a very treatable condition, and the chances for a future healthy pregnancy and baby are excellent," Pollack says.

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