Molar Pregnancy

Posted by e-Medical PPT
Molar pregnancies are an uncommon and very serious complication of pregnancy. The formal medical term for a molar pregnancy is “hydatidiform mole.” Simply put, a molar pregnancy is an abnormality of the placenta,caused by a problem when the egg and sperm join together at fertilization.
There are two types of molar pregnancy, complete and partial. Complete molar pregnancies have only placental parts, and form when the sperm fertilizes an empty egg. Because the egg is empty, no baby is formed. The placenta grows and produces the pregnancy hormone, called HCG, so the patient thinks she is pregnant. Unfortunately, an ultrasound (sometimes called a sonogram) will show that there is no baby, only placenta. A partial mole occurs when 2 sperm fertilize an egg. Instead of forming twins, something goes wrong, leading to a pregnancy with an abnormal fetus and an abnormal placenta. The baby has too many chromosomes and almost always dies in the uterus.
The incidence of molar pregnancy varies depending on where one lives. For example, in the US about 1 out of every 1000 pregnancies is a molar pregnancy. In Southeast Asia the incidence is 8 times higher. Age over 40 is a risk factor for molar pregnancy, as is having a prior molar pregnancy.
Women with a molar pregnancy usually feel pregnant and complain of vaginal spotting or bleeding. Many women with molar pregnancies develop nausea and vomiting. Some even develop rare complications like thyroid disease or very early preeclampsia (toxemia). Preeclampsia occurring earlier than 20 weeks is very worrisome for a molar pregnancy. The ultrasound will often show a “cluster of grapes” appearance or a “snowstorm” appearance, signifying an abnormal placenta. If a baby is present it’s a possible partial mole, while if the baby is absent it’s probably a complete mole. Treatment consists of a D&C (dilation and curettage) of the uterus, where a small vacuum device is inserted into the uterus, under anesthesia, to remove the molar pregnancy. This must be done very carefully or excessive bleeding and blood clots to the lungs can occur.

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