Molar Pregnancy Definition, Reason, Symptoms, Treatment & Prevention
Understanding
A molar pregnancy is a benign tumor that develops in the uterus. In a normal pregnancy, an egg that has been fertilized by a sperm cell will develop into a zygote, embryo, and then a fetus that gets nourishment from the placenta.
However, in a molar pregnancy, the condition of the embryo becomes abnormal and the placenta develops into an abnormal cystic mass.
Molar pregnancy can be divided into two types, namely complete molar pregnancy and partial molar pregnancy. Epidemiological data indicate that about 1 in 1,200 pregnancies are molar pregnancies.
Symptom
At first, molar pregnancy can show signs like pregnancy in general. However, as time goes by, there are some signs and symptoms that can arise in a molar pregnancy, namely:
- Bleeding from the vagina that is bright red or dark brown in the first trimester.
- Intense nausea and vomiting.
- Sometimes, grape-like cysts can come out of the vagina.
- Pelvic floor pain or pressure, which is quite rare.
- The development of the uterus is very fast, beyond normal limits at a certain gestational age.
- Increased blood pressure.
- Ovarian cyst.
- Anemia.
- Increased activity of the thyroid gland.
Reason
Molar pregnancy is caused by an egg that goes through an abnormal fertilization process. Under normal conditions, human body cells have 46 (23 pairs) of chromosomes, where half of the chromosomes are obtained from the father and the other half from the mother.
However, in a complete molar pregnancy, all of the chromosomes from the fertilized egg are obtained from the father. Because shortly after the fertilization process occurs, the chromosomes from the mother’s egg are inactivated, and the chromosomes from the father’s sperm cells are duplicated.
In a partial molar pregnancy, the chromosomes from the egg remain, but the chromosomes from the sperm cells are duplicated. Thus, there are 69 chromosomes instead of the 46 that should be.
Several risk factors are associated with the occurrence of molar pregnancy, namely:
- Mother’s gestational age. Molar pregnancies are more common in pregnant women over 35 years or under 20 years.
- History of previous molar pregnancies.
Diagnosis
To determine the diagnosis of molar pregnancy, it is necessary to conduct a medical interview and physical examination directly by a doctor.
If the doctor suspects a diagnosis of molar pregnancy, certain investigations can be carried out such as ultrasonography (USG) and examination of the hormone beta-human chorionic gonadotropin (-HCG) in the blood.
Ultrasound results in a complete molar pregnancy can show no fetus, no amniotic fluid, a thick placenta with cysts that fill the uterus, and ovarian cysts.
Meanwhile, ultrasound results in partial molar pregnancies can show obstructed fetal growth, very little amniotic fluid, and a thick placenta accompanied by cysts.
Treatment
If a person experiences signs and symptoms similar to a molar pregnancy, it is advisable to consult a doctor immediately. If a woman has a previous molar pregnancy, her doctor may recommend waiting six months to a year before trying to get pregnant again.
In subsequent pregnancies, the doctor will also do an earlier ultrasound examination to monitor the condition and ensure that the fetus is developing properly.
A molar pregnancy cannot be continued as a normal pregnancy. To prevent complications, the molar pregnant tissue must be removed.
Several options for action that can be taken are dilation and curettage (D&C). This is a procedure in which the cervix is dilated and the molar pregnant tissue is removed using a vacuum instrument.
However, if the molar pregnant tissue is large enough and there are no plans for further pregnancies, a hysterectomy or removal of the uterus can be performed.
After the procedure, the doctor will generally monitor the level of the hormone -HCG in the blood for six months to a year afterward, to make sure that no molar pregnant tissue is left behind.