What is Molar Pregnancy?
Hydatidiform mole, also known as molar pregnancy among the people is a disease that can be diagnosed in the first months of pregnancy, where the placenta shows abnormal development and should be taken seriously. In ultrasound examination, it is observed in the uterus as cystic structures in the form of grape grains. Molar pregnancy usually means disruption of the genetic structure of the baby as a result of an incorrect chromosomal junction. The trophoblast cells that provide the baby’s nutrition multiply abnormally, causing many ailments. Molar pregnancy is one of these ailments and it is possible to treat it with appropriate methods. There are two types of this disease, which is not a normal condition, as a full and partial molar pregnancy:
- Complete Molar: The most common type of this occurs by sperm fertilization of the seedless egg cell. There is no tissue belonging to the baby in the placenta. Since the egg is seedless, the placenta continues to develop, but the baby does not develop.
- Partial Molar: In the partial molar pregnancy that occurs as a result of the fertilization of the egg cell by two sperms, the placenta grows more than normal. In the tests performed, tissues belonging to the baby are observed, but since the number of chromosomes is 69, a normal baby cannot develop. In normal pregnancy, a sperm cell fertilizes an egg cell and then the shell around the egg cell closes, not allowing another sperm cell to enter.
What are the Causes of Molar Pregnancy?
- The common incidence of molar pregnancy in Asian countries, (especially in Japan) are 1 in 1000. This rate, which is 1% for those who have experienced this ailment, increases up to 10% for those who experience it twice.
- The age of the mother is one of the most important factors in the formation of this abnormal pregnancy. Molar pregnancy rates of mothers above 35 and under 20 are high.
- This discomfort is more common in women who have low socio-economic levels and are not sufficiently fed.
- This problem is more common in women who are deficient in vitamin A and beta carotene.
What are Molar Pregnancy Symptoms?
All symptoms of normal pregnancies, such as menstrual delay, intense nausea and positive pregnancy tests, also occur in such abnormal conditions. The following symptoms may play a decisive role in the diagnosis of the disease.
- Starting of severe bleeding in the month,
- Nausea and vomiting are very severe,
- Measuring more than 100,000 units of beta HCG hormone in the blood test,
- Parts that look like grains come from the vagina,
- There are brown or bright red currents,
- Occasional formation of ovarian cysts,
- Sudden pregnancy pressure increases,
- Thyroid glands working more than normal.
Molar pregnancy symptoms are partially milder and symptoms may manifest in the coming months.
How is Molar Pregnancy Diagnosed?
- The diagnosis of this disease can be made by the ultrasound method because the findings and feelings may indicate other ailments. Especially in the 5th week, that is, one week after the menstrual delay, an early diagnosis is made in the ultrasound shots.
- Diagnosis of full molar pregnancy is easier. Thanks to the ultrasound, a large number of fluid-filled sachets appear instead of the sachet that should be seen normally. This is a crucial clue in making a diagnosis.
- Measurement of Beta HCG hormone above 100.000 units makes experts suspect about the disease.
- In the examination, the uterus appears larger and above than in its normal month.
- Partial molar is more difficult to diagnose. The appearance of the pouch during the shoot and the presence of fetus-like structures in it can cause confusion with normal pregnancy. For this reason, the placenta should be examined very well.
- The full molar can result in miscarriage at the end of the 16th week and partial moles in the following months, when not usually intervened. In order not to negatively affect the health of the mother, it should be terminated as soon as the diagnosis is made without waiting for the miscarriage.
What Are the Risks of Molar Pregnancy?
- When it is noticed late, it can cause serious problems in terms of the circulatory system of the mother with sudden bleeding.
- Anemia is seen in the expectant mother due to the heavy bleeding.
- Sudden blood pressure spikes are very common. With overwork of the thyroid glands, thyroid crisis may occur and situations that may endanger the mother’s life may arise.
- Sometimes, even if pregnancy is terminated, the remaining cells cover the uterus and can spread into the body through a vein and become a type of cancer called Gestational Trophoblastic Neoplasia (GTN).
Molar Pregnancy Treatment
Since the molar pregnancy is not normal and can cause serious health problems for the mother, the treatment process should be started as soon as the diagnosis is made. This type of pregnancy is not possible as a normal birth and should definitely be terminated by experts in the field. After vaginal ultrasound, it is necessary to diagnose the general health problems of the mother. During the operation to be performed, chest x-ray is taken for preventive purposes, as there is a risk of the diseased cells breaking through the placenta through the blood vessels to reach the lung.
If blood incompatibility is determined by determining the blood group, the mismatch needle (anti Rh immunoglobulin) is made and the mother is taken to abortion surgery under general anesthesia. Experts prefer the method of vacuum abortion in treatment. Since the uterus is larger than normal, complications such as uterine rupture and excessive bleeding may occur during abortion, so it is very important for the health of the mother to perform the operation in a full-fledged hospital. Parts taken after surgery should be taken into pathological examination. Experts may recommend that the entire uterus be removed so that the mother does not experience the same problems again in the coming months if the family had children before.