MOLAR PREGNANCY

Edited by, SNEHA MAVIS

A molar pregnancy, also known as hydatidiform mole, is a rare pregnancy complication characterized by abnormal trophoblast growth, the cells that normally develop into the placenta. A tumour develops in the uterus, causing the placenta to swell into a mass of fluid filled sacs known as cysts. A molar pregnancy occurs in about 1 out of every 1,000 pregnancies (0.1%). Without a placenta, the baby cannot be fed, hence a miscarriage occurs early in the pregnancy.

Complete molar pregnancy and partial molar pregnancy are the two forms of molar pregnancy. The placental tissue is abnormal and enlarged in a complete molar pregnancy, and fluid filled cysts emerge. There is also no foetal tissue formation. Normal placental tissue may coexist with improperly developing placental tissue in a partial molar pregnancy.

A molar pregnancy may appear to be normal at first, but most molar pregnancies have distinct signs and symptoms. Vaginal bleeding, pelvic pain, Severe nausea, vomiting, high blood pressure, and ovarian cysts are all indicators of a molar pregnancy.

An improperly fertilized egg causes a molar pregnancy. Human cells have 23 pairs of chromosomes by default. Each pair has one chromosome from the father and one from the mother. An empty egg is fertilized by one or two sperm in a complete molar pregnancy, and a father provides all of the genetic material. In this case, the mother's chromosome are deleted or inactivated, while the father's chromosomes are duplicated. The mother's chromosomes are retained in a partial or incomplete molar preganancy, but the father contributes two sets of chromosomes. As a result, the embryo now has 69 chromosomes rather than 46. When 2 sperms fertilize an egg, an extra copy of the father's genetic material is produced.

Molar pregnancy is detected during a routine pregnancy ultrasound scan. A grape-like cluster of bloodvessels and tissue can be seen on a pelvic ultrasound during a molar pregnancy. A molar pregnancy could also be indicated by elevated hCG levels in the blood.

A surgical procedure known as dilation and curettage is used to treat molar pregnancy (D&C). The doctor uses special tools to open the cervix and remove tissue from the uterus, during this surgery. It is the best option if the patient wants to get pregnant again. Following a D&C, the doctor may conduct multiple blood tests over the next few months. HCG levels will be checked to see if they are returning to normal.

A full molar pregnancy might result in a syndrome known as chronic gestational trophoblastic disease (GTD) in rare situation. This indicates that the abnormal tissue had spread beyond the uterus and into the muscular layer beneath it. A D&C will not help because it only removes tissue from the uterus. To treat persistent GTD, one may need a hysterectomy or chemotherapy. One should not conceive for a year after a molar pregnancy.