Molar Pregnancy (Gestational Trophoblastic Disease)
Abnormal placental tissue growth instead of normal pregnancy - requires treatment.
Affects: 1 in 1000 pregnancies in US
Overview
Molar pregnancy is a rare condition where abnormal tissue grows in the uterus instead of a normal embryo and placenta. It's caused by genetic errors during fertilization resulting in abnormal cell growth.
There are two types: complete molar (no embryo forms) and partial molar (some embryonic tissue but not viable). The abnormal tissue produces very high levels of pregnancy hormone (hCG).
Treatment involves removing the tissue by D&C. Close follow-up is essential because molar tissue can become cancerous. With proper treatment and monitoring, outcomes are excellent.
🩺 Symptoms
- •Vaginal bleeding (dark brown to bright red)
- •Severe nausea and vomiting
- •Rapidly growing uterus (larger than expected)
- •Pelvic pressure or pain
- •Passage of grape-like tissue
- •High blood pressure early in pregnancy
- •Preeclampsia before 20 weeks
- •Hyperthyroidism symptoms
- •Ovarian cysts
🔍 Causes
- →Genetic error during fertilization
- →Complete molar: Egg with no genetic material fertilized
- →Partial molar: Egg fertilized by two sperm
- →Results in abnormal chromosome numbers
- →Causes abnormal cell growth
⚠️ Risk Factors
- •Maternal age under 20 or over 35 (especially over 40)
- •Previous molar pregnancy (1-2% recurrence)
- •Previous miscarriage
- •Diet low in protein, folate, and carotene
- •Asian ethnicity
- •Blood type A
🔬 Diagnosis
- →Ultrasound showing "snowstorm" pattern
- →No embryo or fetal heartbeat visible
- →Extremely high hCG levels
- →Uterus larger than expected for dates
- →Tissue examination after D&C confirms
💊 Treatment
- ✓D&C (dilation and curettage) to remove tissue
- ✓May need repeat D&C if tissue remains
- ✓RhoGAM if mother Rh-negative
- ✓hCG monitoring weekly until undetectable
- ✓Then monthly monitoring for 6-12 months
- ✓Chest X-ray to check for spread
- ✓Chemotherapy if tissue becomes cancerous (rare)
- ✓Avoid pregnancy during monitoring period
- ✓Use reliable contraception
🛡️ Prevention
- →Cannot be prevented
- →Adequate nutrition before pregnancy
- →Folate supplementation
- →After molar pregnancy, wait to conceive until cleared
⚠️ Potential Complications
- !Heavy bleeding
- !Infection
- !Persistent gestational trophoblastic disease (15-20%)
- !Choriocarcinoma (cancerous, rare)
- !Need for chemotherapy
- !Emotional trauma from loss
- !Anxiety about future pregnancies
- !With proper treatment, cure rate over 90%
🚨 When to Call Your Doctor
Contact your healthcare provider immediately if you experience:
- ⚠Vaginal bleeding in early pregnancy
- ⚠Severe nausea and vomiting
- ⚠Passage of tissue or clots
- ⚠Pelvic pain
- ⚠Signs of hyperthyroidism (rapid heartbeat, tremors)
- ⚠During follow-up: Rising or plateauing hCG levels
Related Conditions
This information is for educational purposes and should not replace medical advice. Always consult your healthcare provider for personalized guidance.