In the long list of known pregnancy complications, one lesser-known and rare condition is molar pregnancy, scientifically known as a hydatidiform mole. It is very distressing to learn about this rare condition, but awareness is crucial as it helps women recognise unusual symptoms and make informed decisions at the right time.

In this blog, let us dig deeper into how molar pregnancy affects both mother and pregnancy and the necessary steps to take if you are diagnosed.

What is a Molar Pregnancy?

Molar pregnancy, or hydatidiform mole, is a common form of gestational trophoblastic neoplasm (a type of tumour caused by abnormal growth of placental cells, which can be benign or cancerous) usually detected in the first 12 weeks of pregnancy (first trimester). In a typical pregnancy, a fertilised egg implants itself in the uterus and develops into an embryo. However, in a molar pregnancy, fertilisation goes wrong, leading to the formation of a cluster of rapidly growing, tiny, water-filled sacs instead of a normal embryo. These sacs develop into a non-cancerous tumour that must be removed surgically. If not treated on time, it can result in severe complications.

Prevalence of Molar Pregnancy

Molar pregnancy is a rare condition, but its frequency varies by region. In Asia, it occurs in approximately 1 in 77 pregnancies and 1 in 57 deliveries. For instance, in India and the Middle East, the occurrence is estimated to be around 1 in 160 pregnancies.

Types of Molar Pregnancy

Based on how placental tissue develops, molar pregnancy is categorised into two types. They are:

1. Complete Molar Pregnancy

In the case of complete molar pregnancies, a sperm fertilises an empty egg, leading to no embryo formation. Instead, abnormal placental tissue develops, which can cause a positive pregnancy test. This occurs because the abnormal tissue produces the HCG hormone, just like a healthy placenta.

2. Partial Molar Pregnancy

As the name indicates, a partial molar pregnancy involves the partial development of both the placenta and the foetus. However, due to genetic abnormalities, this incomplete foetal tissue cannot survive.

Common Molar Pregnancy Symptoms

Recognising the symptoms of molar pregnancy is very important, as they can often look like normal pregnancy. Common signs include.

• Vaginal bleeding
• Enlarged uterus
• Hyperemesis gravidarum (severe nausea and vomiting)
• Preeclampsia-like symptoms
• Abdominal pain
• Elevated HCG
• Anemia

Potential Risk Factors Of Molar Pregnancy

Molar pregnancy is associated with various risk factors. Recognising these risks is crucial for early detection and effective management. The potential risk factors include:

• Women at extremes of reproductive age, particularly teenagers and those aged 40–50 years.
• A history of spontaneous abortion increases susceptibility.
• Previous molar pregnancy significantly raises the recurrence risk.
• Usage of oral contraceptive pills is associated with a higher risk.
• Ovulation induction drugs for infertility treatments increase incidence rates.
• Higher risk observed with an increased number of previous pregnancies.
• Maternal blood groups A and AB are linked to greater risk.
• Smoking and exposure to pesticides or herbicides contribute to risk.
• Genetic factors, such as mutations in tumor-suppressor genes and oncogene expression, play a role.

Causes Of Molar Pregnancy

A molar pregnancy occurs due to genetic abnormalities in the chromosomes. In a normal pregnancy, the fertilised egg receives 23 chromosomes from the mother and 23 from the father, forming a complete set. However, in a partial molar pregnancy, the egg is fertilised by two sperm cells, resulting in an embryo with 69 chromosomes. This abnormal chromosomal count often leads to a miscarriage. On the other hand, a complete molar pregnancy occurs when the fertilised egg only receives chromosomes from the sperm, with no maternal chromosomes involved, leading to the absence of a viable embryo.

Complications During Future Pregnancies

A molar pregnancy typically does not impact future pregnancies. There is no increased risk of birth defects or other complications in subsequent pregnancies. However, it is important for individuals to follow up with their healthcare provider for proper monitoring and care in future pregnancies.

How is Molar Pregnancy Diagnosed?

Molar pregnancy can be diagnosed in two primary ways: through ultrasound and blood tests. During an ultrasound, typically in the first trimester, the uterus may show fluid-filled sacs instead of a normal placenta.

The second diagnostic method involves measuring human chorionic gonadotropin (HCG) levels in the blood. In cases of molar pregnancy, HCG levels are usually higher than normal, which is a key indicator. These tests help healthcare providers confirm the diagnosis and plan for appropriate care. as early diagnosis and appropriate intervention can prevent serious complications.

Conclusion

Although molar pregnancy is uncommon, it is essential for women to be aware of the causes, symptoms, risk factors, and diagnostic methods. Early recognition of the signs can help women seek prompt medical attention, reducing the risk of complications. While it can be distressing, a molar pregnancy does not typically affect future pregnancies, and with proper monitoring and care, women can go on to have healthy pregnancies. By staying informed, women can make empowered decisions and ensure they receive the necessary care if diagnosed with this condition.

Frequently Asked Questions:

1. Can Molar Pregnancy Be Prevented?

Currently, there are no known methods to prevent a molar pregnancy. It occurs due to random genetic errors during fertilisation, and no specific lifestyle changes or interventions have been identified to reduce its occurrence.

2. Is A Molar Pregnancy A Type Of Miscarriage?

Yes, a molar pregnancy is considered a type of miscarriage. It involves the loss of a pregnancy due to abnormal fertilisation, leading to the growth of non-viable tissue instead of a healthy foetus.

3. What Causes A Hydatidiform Mole?

Typically, an embryo receives 23 chromosomes from each parent, resulting in a balanced genetic makeup. However, in a molar pregnancy (hydatidiform mole), this process fails, resulting in chromosomal imbalance. This genetic mistake results in abnormal tissue growth instead of a healthy embryo.

4. How Is A Molar Pregnancy Treated?

There is no specific cure for a molar pregnancy, but it is treated by removing the abnormal tissue. This is usually done through a surgical procedure, such as suction dilation and curettage (D&C). In rare cases, a hysterectomy may be required, especially if there are complications. In some instances, medication may also be used to help expel the uterine contents.

Article Source :

This article was originally published on

https://www.lifecell.in/blog/general/why-is-a-molar-pregnancy-not-common