Molar Pregnancy- Symptoms, Diagnosis And Treatment

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Written by Editorial Team

Editorial Team

With a rich experience in pregnancy and parenting, our team of experts create insightful, well-curated, and easy-to-read content for our to-be-parents and parents at all stages of parenting..

Molar Pregnancy
Your wait for the grand adventure of motherhood is a really challenging time because this experience will change you mentally and physically forever. One of the most unfortunate and grieving complications during pregnancy is the loss of the baby within the womb. Although rare, molar pregnancy is one such issue about which most of us are unaware. This disease tricks your body of being pregnant wherein actually you may not be, or will eventually lose the baby.

What is Molar Pregnancy

Molar pregnancy (hydatidiform mole) is also known as gestational trophoblastic disease (GTD) – gestational = pregnancy, trophoblastic = placenta related. Placenta is the tissue which is essential for the growth of the baby and is not present in women who are not pregnant. Molar pregnancy is basically a fertilization error which leads to chromosomal mix up. This leads to the abnormal cell growth in placenta and forms fluid filled clusters/sacs in the womb. These obstruct the development of baby.

Types of Molar Pregnancy

Molar pregnancy can either be

Complete: All the symptoms of pregnancy exist and the blood test confirms the hCG (hormone human chorionic gonadotropin) levels which is produced during pregnancy. However the ultrasound scan will not show the fetus, rather parts of placenta. This happens when a sperm fertilizes an empty egg, one that has no genetic information and hence there is no baby. The placenta grows and leads to the formation of hCG in the body. The abnormal tissue forms a lump and grows into the uterus
Partial: Herein, the ultrasound scan may show fetus but this fetal tissue is abnormal and will not develop into a baby. This happens when two sperms fertilize an egg – this leads to overdose of chromosomes for the embryo. This causes rapid abnormal growth in the placenta which quickly consumes the embryo

Sometimes the abnormal growth of cells in placenta can spread to other organs. If not treated timely, these may become cancerous. Although very rare, sometimes a seemingly twin pregnancy can be one fetus and one molar pregnancy. Therefore it is advised and preferred to continuously monitor the pregnancy and watch out for the symptoms of a molar pregnancy.

Symptoms of Molar Pregnancy

Molar pregnancy exhibits the usual symptoms of pregnancy such as missed periods and morning sickness along with :

Heavy vaginal bleeding: usually between 6-12 weeks of pregnancy
Passing blood clots
Watery reddish/brownish discharge which may be continuous or intermittent
Passing pieces of molar tissue from the vagina, which appears like bunch of grapes
Severe nausea and vomiting
Abdominal cramping
Early abdominal swelling: unusually bigger abdomen
Smaller abdomen: smaller abdomen as compared to that expected during the respective stage of pregnancy
Hyperthyroidism: Increased production of hormones by thyroid
Hyperemesis: frequent and severe feeling of being sick
High hCG levels: higher hCG levels than in normal pregnancy
Preeclampsia: high blood pressure and protein (detected in urine) are common in last 3 months of pregnancy but in molar pregnancy this occurs early
Anaemia: losing too much blood from vagina can lead to fatigue and feeling unwell
No foetal movement or heart rate detection

Sad couple

Causes of Molar Pregnancy

Ethnicity:Asian women are at an increased risk of developing molar pregnancy. 1 in every 390 pregnancies in Asian women is molar pregnancy
Age:Women in teens or above 40 years are more prone to molar pregnancy
Previous history:Women who have had 2 or more miscarriages are more likely to develop molar pregnancy
Low carotene diet:Deficiency of carotene which is found in Vitamin A may lead to molar pregnancy
Birth control pill:Oral contraceptive may cause molar pregnancy

Diagnosis of Molar Pregnancy

Ultrasound scan:
- Appearance of placenta: Evidence of fluid filled sacs present in clusters – abnormal growth
- Uterus: enlarged or smaller than that expected during the respective stage of pregnancy
- Ovaries: enlarged or smaller than the expected size
Blood test:
- hCG level: higher than that observed during normal pregnancy
- Protein: higher than normal serum level
Lab tests: The abnormal tissues are sent to the laboratory to identify molar pregnancy
Placenta check up: The obstetrician may observe the placenta under microscope to check for any abnormal growths

Treatment of Molar Pregnancy

A molar pregnancy can have serious complications; hence it is imperative to get it treated right away. Though most of them are non-cancerous tumour (benign), yet a few cases of cancerous tumour have also come to be seen. Molar pregnancy is treated as follows:

Dilation and curettage: The abnormal tissue in the womb has to be removed surgically. In this procedure, the cervix is widened and the tissue is removed with a gentle suction. An instrument called curette is then used to scrape out any remaining molar tissues from the uterus wall
Medical evacuation: In case of partial molar pregnancy, the doctor may give medicine in the form of tablets to swallow, gel, or a pessary to insert into the vagina. These contract the uterus and help emptying the tissues
Chemotherapy: Sometimes after dilation and curettage procedure, the abnormal cells may remain and spread to other parts of the body. This condition may be identified with increased hCG levels even after 8 weeks of the procedure. Methotrextate – very mild and effective chemotherapy is performed which successfully removes the remaining abnormal cells
Hysterectomy: i.e. removal of the womb, is very rarely performed. However, in cases, where a woman does not want any more children or has persistent heavy bleeding and fibroids

Do’s and don’ts after Molar Pregnancy Surgery

Birth control pill is not recommended as they disturb hormones
Intra-uterine device is prohibited
Refrain from becoming pregnant for one year after chemotherapy
Avoid conceiving till the hCG level drops to zero
Other contraceptives such as condoms and diaphragms may be used
A strict and religious follow-up consisting of routine blood (hCG level)/urine (protein serum) is strongly advised
Genetic counselling is recommended for next pregnancy

It is obvious to be depressed and confused with the loss of baby. You and your partner should speak with the doctor and alert him with any of the above symptoms. Fortunately, this condition can be successfully treated and you may enjoy a healthy pregnancy soon after!

Editorial Team,

With a rich experience in pregnancy and parenting, our team of experts create insightful, well-curated, and easy-to-read content for our to-be-parents and parents at all stages of parenting.Read more.

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