Written by Dr.M.D.Mazumdar, MD
Molar pregnancy is an abnormal pregnancy in which the chorionic villi surrounding the ovum is converted into a mass of cysts or vesicles of varying sizes.
Molar pregnancy is also called Gestational Trophoblastic Disease and the abnormally developing ovum is called the vesicular Mole or the Hydatidiform Mole. The name comes from the similarity to the hydatid cysts formed in infections by liverflukes.
A Molar pregnancy results from over-production of the tissue that is supposed to develop into the placenta.
The cause of the occurance of molar pregnancy is still under research, but it is believed to be paternal in origin. The mole shows two X-chromosomes which have been identified as coming from the male partner. It is thought that fertilization of an ovum by a sperm carrying two X-chromosomes or by two sperms carrying an X-chromosome each, causes the development of a vesicular mole (normal sperms carry either a X- or a Y-chromosome).
Molar pregnancy usually starts developing from the 8th week of pregnancy, although it has been identified as early as the 3rd week.
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The most feared complication of Hydatidiform Mole is Choriocarcinoma. This is a malignant form of the disease which can occur simultaneously with the development of the mole, or later, after 6 months of evacuation of the Mole.
Other complications are hemorrhage, sepsis or perforation of the uterus.
Treatment of Molar Pregnancy
The broad guidelines of treatment are:
Serum HCG levels are measured every 2 weeks until it reaches normal levels (usually in about 4 weeks time after delivery), then monthly for 6 months, then 2 monthly for another 6 months, then 6 monthly for the next 1 year. This makes up a total follow-up time of 2 years.
The patient is not allowed to get pregnant within this time. She should use barrier contraceptives like condoms. Hormone containing contraceptives like birth control pills should be taken.
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