Molar Pregnancy Treatment

In a molar pregnancy the tissue that should have formed the placenta grows abnormally, and a normal baby does not develop. It arises from a fault at the moment of fertilisation. In a complete mole the egg contributes no genetic material and no foetus forms at all. In a partial mole the egg is fertilised by two sperm, so there is too much genetic material, and any foetal tissue present cannot survive.

Nothing you did caused it and nothing you could have done would have prevented it. It is slightly commoner at the two ends of reproductive life, under about twenty and over about forty, and it is reported more often in Asia than in Europe. Having had one raises the chance of another modestly, and most women who have had a molar pregnancy go on to have a normal pregnancy afterwards.

Molar tissue produces large amounts of the pregnancy hormone hCG, far more than a normal pregnancy of the same dates. That hormone is the thread running through everything: it is what raises the suspicion, it is what the treatment is checked against, and it is what the follow-up measures month after month.

It is usually picked up on an ultrasound arranged for bleeding in early pregnancy, or at a routine early scan. The uterus is often larger than the dates predict, and the scan shows a characteristic appearance of the tissue where a developing pregnancy should be. A blood hCG far above what the dates would give supports it.

Your doctor also examines you for the effects of that high hormone level, which can include severe and persistent vomiting, an overactive thyroid, and raised blood pressure appearing earlier in pregnancy than it ever normally would. A blood count and your blood group are checked, because Anti-D is given to women who are Rhesus negative, and a chest X-ray is sometimes taken as a baseline.

The diagnosis is confirmed only once the tissue has been removed from the uterus and examined under a microscope. That examination also says whether the mole is complete or partial, and the answer changes how long and how closely you are followed afterwards.

Emptying the uterus is a Day Care procedure and the physical recovery from it is short: cramping for a day or two, bleeding that settles over one to two weeks, and most women back to ordinary activity within a few days. Your next period usually arrives in four to eight weeks.

The follow-up is the long part, and it is the treatment as much as anything done on the day. Your hCG is measured at set intervals, close together at first and then monthly, until it has been normal for a defined stretch of time. For most women that means blood tests continuing for about six months from the point the level first becomes normal, and your doctor will give you the schedule in writing.

You will be advised to use reliable contraception for the whole of the follow-up. A new pregnancy raises hCG on its own, and that makes the single measurement everything depends on impossible to interpret. Emotionally this is a pregnancy loss with an unusually long tail, and asking for support through it is reasonable at any point.