How.does a molar pregnancy happen?
A molar pregnancy occurs when an egg and sperm join incorrectly at fertilization and a noncancerous tumor forms instead of a healthy placenta. The tumor, or mole, cannot support a developing embryo, and the pregnancy ends. It is also called a hydatidiform mole.
A molar pregnancy is a noncancerous tumor that develops inside the uterus. A molar pregnancy occurs when the placenta develops into a collection of cysts (similar to sacs) and does not develop into a healthy pregnancy with healthy placental tissue and an embryo.
In a complete molar pregnancy, there is no healthy placental tissue at all, and there is no fetus as well. In contrast, in a partial molar pregnancy, there is little healthy placental tissue in addition to the unhealthy fetal tissue, and therefore a live fetus cannot be formed.
A molar pregnancy can turn into a rare type of cancer, so this condition must be treated urgently. Careful follow-up of the course of a molar pregnancy is important in order to reduce the complications of this problem and to allow for a healthy pregnancy in the future.
Symptoms of a molar pregnancy
Shows pregnancy in the early stages of pregnancy cluster, Salim Lamb, but then begin the symptoms of pregnancy cluster appear , namely:
- Vaginal bleeding that appears in the first trimester of pregnancy and is often dark brown to bright red.
- severe nausea and vomiting;
- A cyst comes out, its shape is like grapes.
- Sensation of pressure or pain in the pelvic area.
During the examination we can note the following things:
- Very rapid enlargement of the uterus, meaning that the size of the uterus is too large in relation to the size of the uterus that is supposed to be at this stage of pregnancy.
- high blood pressure.
- Eclampsism ( (Preeclampsia
- Ovarian cysts.
- Poverty tail (Anemia) .
- Overactive thyroid ( Hyperthyroidism ).
Causes and risk factors for a molar pregnancy
In a healthy pregnancy, the egg is fertilized by the mother, by the father’s sperm, and it contains 46 chromosomes.
23 chromosomes come from the mother’s egg and the remaining 23 come from the father’s sperm.
In a full molar pregnancy, all chromosomes come from the father, due to the loss of chromosomes that come from the mother, and the duplication of the paternal source chromosomes.
In a partial molar pregnancy, there is no loss of chromosomes that come from the mother, but a double set of chromosomes comes from the father, meaning that the fertilized egg contains 69 chromosomes.
A partial molar pregnancy occurs when there is a doubling of the number of chromosomes that come from the father, or after the fertilization of a single egg by two different sperms.
A hydatid pregnancy occurs at a rate of 1 in every 1,000 births.
However, there are several risk factors for a molar pregnancy:
- Age – Hydatid pregnancy is more common in pregnancies that occur in women who are 35 and over, or girls under the age of 20.
- Previous hydatid pregnancy – the probability of a hydatid pregnancy in women who have previously had a hydatid pregnancy is 10 times higher than that of other women.
- Ethnic groups – Hydatid pregnancy is more common in women of Southeast Asian descent.
Complications of a molar pregnancy
In 10% of cases after miscarriage of a molar pregnancy and expulsion of diseased placental tissue, hydatid tissue that continues to grow (GTD) remains in the uterus.
This can be seen when a blood test shows high levels of the pregnancy hormone. Vaginal bleeding occurs if the hydatid tissue has penetrated the layers of the uterus.
This condition requires chemotherapy, and in general it ends successfully. There is the possibility of treating a molar pregnancy by another method, which is a hysterectomy.
Very rarely, hydatid tissue develops into cancerous tissue – choriocarcinoma and may spread to other parts of the body. Choriocarcinoma treatment also depends on the combination of chemotherapy drugs, and is usually successful.
Diagnosis of a molar pregnancy
In the first stage, we can notice an increase in the level of the pregnancy hormone (HCG- Human chorionic gonadotropin).
On the ultrasound examination (US), which is preferably performed at this stage through the vagina, it is often possible to notice the absence of a fetus, the absence of amniotic fluid, a thick and cyst-filled placenta filling the uterine cavity, and the presence of cysts in the ovaries . Symptoms in a partial hydatid pregnancy are less severe and more partial.
If a hydatid pregnancy is diagnosed or suspected, the presence of anemia, hyperthyroidism , and whether the woman suffers from preeclampsia should be examined.
Molar pregnancy treatment
There is no chance that a molar pregnancy will turn into a healthy pregnancy, so the molar pregnancy should be removed as soon as possible.
The pregnancy is removed by surgery, which can be done under local or general anesthesia. The duration of the surgery is short, and usually lasts from 15 minutes to 30 minutes.
The operation is performed through the vagina and does not require an abdominal incision. If the volume of hydatid tissue is large, and the woman does not want to have children, the entire uterus can be removed .
After the surgery, the level of pregnancy hormone in the blood is monitored, to make sure that the hydatid tissue has been completely removed.
After the hormone level returns to the normal level, follow-up continues for half a year and up to a year. During this period, the doctor may advise against pregnancy to ensure that the increase in pregnancy hormone is not caused by the development of new hydatid tissue.
Prevention of molar pregnancy
It is recommended to closely follow up the cases in which women have had a molar pregnancy, and to supervise them in the early stages of the next pregnancy, as the probability of their hydatid pregnancy is 10 times that of other women.
It is important to remember that aborting a fetus is a difficult and frustrating process, so it is important to wait after a molar pregnancy and give the body and soul enough time to recover from the trauma.
There are support groups via the Internet, through which others can share their personal experience, and condolences are received from other women who have gone through the same experience.