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What is Molar pregnancy?
Molar pregnancy (also known as hydatidiform mole) results from a genetic error during the process of fertilization, which leads to the abnormal development of trophoblastic tissue within the uterus. The presentation of the mole gives the impression of grape stems.
There are two types:
1. complete molar pregnancy
2. partial molar pregnancy
What is complete Molar pregnancy?
In this type, we only have trophoblastic tissue in the absence of an embryo. The increase of the trophoblast, entails an increase of the pregnancy hormone (beta chorionic gonadotrophin) resulting, thus, in the impression that there is normal pregnancy.
During an ultrasound examination, the absence of the embryo will be established, along with the excess production of trophoblast.
What is partial Molar pregnancy?
In partial molar pregnancy, there exists both an abnormal increase of trophoblast production and the formation of an embryo which, after a restricted period of time, it regresses, i.e. its development and cardiac function are disrupted, if it had reached that stage at all.
What are the causes?
In the case of COMPLETE MOLAR PREGNANCY, an ovium lacking genetic material, i.e. without any chromosomes, is fertilised by one, usually, by one spermatozoon. Thus, all of the genetic information within the fertilised ovium is derived from the father. The result of this unnatural state, is that a fetus cannot be formed, but only abnormal trophoblastic tissue.
PARTIAL MOLAR PREGNANCY is also a genetic “mistake”. In a normal pregnancy, 23 chromosomes participate that originate from the mother and another 23 from the father. When partial molar pregnancy occurs, the ovium receives two sets of genetic material from the father, usually because 2 spermatozoa have fertilised it. Thus, instead of 46 chromosomes (23 from the mother and 23 from the father), the fertilised ovium contains 69 chromosomes.
Which women are most at risk ?
- Approximately 1 in 1000 pregnancies in Caucasian women will end up in molar pregnancy.
- Women who are over 49 years of age.
- Women with more than two spontaneous miscarriages.
- Women who have had a molar pregnancy in the past.
What are the symptoms?
- Vaginal bleeding
- Nausea and vomiting
- Frequent hypertension
- Rarely, thyroid dysfunction
- Large increase in the levels of beta-chorionic gonadotrophin.
Via ultrasound examination we may reach a diagnosis
Treatment
We will need to carry out a therapeutic abrasion of the uterus. The material will be sent for a biopsy in order to determine the diagnosis.
Almost 90% of women who present with molar pregnancy do not require supplementary treatment. One month after the initial results, we will have a beta-chorionic check and monitor it until it reaches normal levels.
In few cases the trophoblast levels will rise again.
What distinguishes molar pregnancy from other miscarriages, is that it greatly affects the mother’s health as well. (Thankfully, it will rarely develop into an invasive mole or a choriocarcinoma).
Can it reoccur?
If you get pregnant during the first year after having given birth, there is an increased possibility that molar pregnancy will re-occur. Later on, the possibility is 1–2%
