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What is a molar pregnancy?
In a molar pregnancy, the early placenta develops into a mass of cysts (called a hydatidiform mole) that resemble a bunch of white grapes. The embryo either does not form at all or is malformed and cannot survive. About 1 in 1,500 pregnancies is molar (7). Women who are over age 40 or who have had a previous molar pregnancy are at increased risk of molar pregnancy (8).
There are two types of molar pregnancy, complete and partial. With a complete mole, there is no embryo and no normal placental tissue. With a partial mole, there may be some normal placenta and the embryo, which is abnormal, begins to develop.
Both types of molar pregnancy arise from an abnormal fertilized egg. In a complete mole, all of the fertilized egg's chromosomes (tiny thread-like structures in cells that carry genes) come from the father (8). Normally, half come from the father and half from the mother. In a complete mole, shortly after fertilization, the chromosomes from the mother's egg are lost or inactivated, and those from the father are duplicated. In most cases of partial mole, the mother's 23 chromosomes remain, but there are two sets of chromosomes from the father (so the embryo has 69 chromosomes instead of the normal 46) (8). One way this happens is fertilization of an egg by two sperm cells.
Molar pregnancy poses a threat to the pregnant woman because the condition can result in heavy bleeding. Occasionally, a mole can turn into a choriocarcinoma, a rare pregnancy-related form of cancer.
What are the symptoms of a molar pregnancy?
A molar pregnancy may start off like a normal pregnancy. Around the tenth week, vaginal bleeding, which often is dark brown in color, usually occurs. Other common symptoms include severe nausea and vomiting, abdominal cramps (from a uterus that is too large due to the increasing number of cysts), and high blood pressure.
How is a molar pregnancy diagnosed?
An ultrasound examination can diagnose a molar pregnancy. The provider also measures the levels of hCG, which often are higher than normal with a complete mole, and lower than normal with a partial mole.
How is a molar pregnancy treated?
A molar pregnancy is a frightening experience. Not only does the woman lose a pregnancy, she learns that she has a slight risk of developing cancer. To protect the woman, all molar tissue must be removed from the uterus. This usually is done using a D&C under general anesthesia. Occasionally, when the mole is extensive and the woman has decided against future pregnancies, a hysterectomy may be performed.
After mole removal, the provider again measures the level of hCG. If it has dropped to zero, the woman generally needs no additional treatment. However, the provider will continue to monitor hCG levels for six months to one year to be sure there is no remaining molar tissue (7). A woman who has had a molar pregnancy should not become pregnant for six months to one year, because a pregnancy would make it difficult to monitor hCG levels (7).
How often do moles become cancerous?
After the uterus is emptied, about 20 percent of complete moles and less than 5 percent of partial moles persist, and the remaining abnormal tissue may continue to grow (7, 8). This is called persistent gestational trophoblastic disease (GTD). Treatment with one or more cancer drugs cures GTD nearly 100 percent of the time. Rarely, a cancerous form of GTD, called choriocarcinoma, develops and spreads to other organs. Use of multiple cancer drugs is successful at treating this cancer.
What is the outlook for future pregnancies after a molar pregnancy?
If a woman has a molar pregnancy, her outlook for a future pregnancy is good. The risk that a mole will develop in a future pregnancy is only 1 to 2 percent (7).
What is a molar pregnancy?
In a molar pregnancy, the early placenta develops into a mass of cysts (called a hydatidiform mole) that resemble a bunch of white grapes. The embryo either does not form at all or is malformed and cannot survive. About 1 in 1,500 pregnancies is molar (7). Women who are over age 40 or who have had a previous molar pregnancy are at increased risk of molar pregnancy (8).
There are two types of molar pregnancy, complete and partial. With a complete mole, there is no embryo and no normal placental tissue. With a partial mole, there may be some normal placenta and the embryo, which is abnormal, begins to develop.
Both types of molar pregnancy arise from an abnormal fertilized egg. In a complete mole, all of the fertilized egg's chromosomes (tiny thread-like structures in cells that carry genes) come from the father (8). Normally, half come from the father and half from the mother. In a complete mole, shortly after fertilization, the chromosomes from the mother's egg are lost or inactivated, and those from the father are duplicated. In most cases of partial mole, the mother's 23 chromosomes remain, but there are two sets of chromosomes from the father (so the embryo has 69 chromosomes instead of the normal 46) (8). One way this happens is fertilization of an egg by two sperm cells.
Molar pregnancy poses a threat to the pregnant woman because the condition can result in heavy bleeding. Occasionally, a mole can turn into a choriocarcinoma, a rare pregnancy-related form of cancer.
What are the symptoms of a molar pregnancy?
A molar pregnancy may start off like a normal pregnancy. Around the tenth week, vaginal bleeding, which often is dark brown in color, usually occurs. Other common symptoms include severe nausea and vomiting, abdominal cramps (from a uterus that is too large due to the increasing number of cysts), and high blood pressure.
How is a molar pregnancy diagnosed?
An ultrasound examination can diagnose a molar pregnancy. The provider also measures the levels of hCG, which often are higher than normal with a complete mole, and lower than normal with a partial mole.
How is a molar pregnancy treated?
A molar pregnancy is a frightening experience. Not only does the woman lose a pregnancy, she learns that she has a slight risk of developing cancer. To protect the woman, all molar tissue must be removed from the uterus. This usually is done using a D&C under general anesthesia. Occasionally, when the mole is extensive and the woman has decided against future pregnancies, a hysterectomy may be performed.
After mole removal, the provider again measures the level of hCG. If it has dropped to zero, the woman generally needs no additional treatment. However, the provider will continue to monitor hCG levels for six months to one year to be sure there is no remaining molar tissue (7). A woman who has had a molar pregnancy should not become pregnant for six months to one year, because a pregnancy would make it difficult to monitor hCG levels (7).
How often do moles become cancerous?
After the uterus is emptied, about 20 percent of complete moles and less than 5 percent of partial moles persist, and the remaining abnormal tissue may continue to grow (7, 8). This is called persistent gestational trophoblastic disease (GTD). Treatment with one or more cancer drugs cures GTD nearly 100 percent of the time. Rarely, a cancerous form of GTD, called choriocarcinoma, develops and spreads to other organs. Use of multiple cancer drugs is successful at treating this cancer.
What is the outlook for future pregnancies after a molar pregnancy?
If a woman has a molar pregnancy, her outlook for a future pregnancy is good. The risk that a mole will develop in a future pregnancy is only 1 to 2 percent (7).