What is a Molar Pregnancy?

I wanted one of my first blog posts to address what a molar pregnancy is and to bring awareness to it. Molar pregnancy happens to 1 in 1,000 pregnancies in the United States, so it is rare. 0.10%

A hydatidiform mole, also known as a molar pregnancy is a type of pregnancy complication where there is abnormal growth of trophoblasts, the cells that normally develop into the placenta. The abnormal growth of the placental tissue develops into cysts within the uterus. In some cases, these cysts can develop into a rare form of cancer - gestational trophoblastic disease (Choriocarcinoma).

There are two types of molar pregnancy: a complete molar pregnancy and a partial molar pregnancy.

A complete molar pregnancy is when an empty egg is fertilized by 1 or 2 sperm, so there is no genetic material from the mother, only the father. Fetal tissue does not form.

A partial molar pregnancy is when the egg is fertilized by 2 sperm.

A normal pregnancy contains 23 pairs of chromosomes - one half from the sperm and one half from the egg.

See image below to get a visual:

Sadly, when an egg is fertilized in either of these ways, a baby is unable to grow or would never fully develop. With a complete molar pregnancy, no fetal tissue forms at all. Molar pregnancies still release the pregnancy hormone (hCG), so women still get positive pregnancy tests and show symptoms of pregnancy.

Some women experience vaginal bleeding, severe nausea, pelvic pain, rapids uterine growth. Others may experience no symptoms at all.

Most molar pregnancies are diagnosed via ultrasound or by examining the tissue removed from a D&C.

Treatment includes monitoring hCG levels to ensure that molar tissue does not remain or grow after it has been removed. If there is any molar tissue left behind and/or it grows, this is referred to as gestational trophoblastic neoplasia (GTN). If GTN occurs, it can become cancerous (Choriocarcinoma) and can spread to other organs. Choriocarcinoma occurs in 15 - 20% of complete molar pregnancies and in 5% of Partial Molar Pregnancies. It would have to be treated with chemotherapy. Once you hCG levels return to normal your doctor may recommend you wait 6 to 12 months before trying to conceive again and they will recommend you take some sort of birth control during this time to ensure you do not become pregnant. That way if your hCG levels rise, they know it's because of GTN and not because of pregnancy.

In my case, I had no symptoms to indicate otherwise that this was not a normal pregnancy. Looking back now, I did experience rapid uterine growth, but I just thought I was bigger because this was my third child. My complete molar pregnancy was diagnosed by ultrasound and then confirmed by examination of the molar tissue from my D&C. The ultrasound was odd looking, there were these grape-like circles all over (what I now know were the abnormal trophoblasts) and an empty gestational sac.

That is when I was told "there is no baby" at my 8-week ultrasound. Instead of a baby, tumors grew. My hCG levels on that day were 90,051 and then the day of my D&C (5 days later) they were 155,076. I had weekly blood draws to ensure my hCG levels lowered. It took 7 weeks for my levels to be below 5 (which is considered negative). Then I did monthly tests to ensure my levels stayed below 5 for six consecutive months. Which they did. Luckily for me I did not have to go through chemotherapy treatment.

Going through a molar pregnancy is extremely difficult for women. After a molar pregnancy you cannot just try again, you have to be monitored for 6-12 months to ensure HCG levels stay below 5 and that the tumor does not grow back. You are emotionally devastated to learn that you have lost a pregnancy, then you feel isolation from the rarity of your diagnosis, and then there is a chance you may need chemotherapy! It's an incredible amount of emotions you are forced to bear. On top of all that, you have to be monitored weekly and then monthly which makes it difficult to move forward with your grief.

If you have questions, please ask.

-Katie

Source: https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/diagnosis-treatment/drc-20375180