Molar Pregnancy Causes, Prevention And Treatment
Some pregnancies sometimes need to be aborted because of certain pregnancy problems, one of which is a molar pregnancy. This condition needs to be detected and treated as early as possible.
What Is Molar Pregnancy?
Molar pregnancy ( molar pregnancy ) is a pregnancy complication characterized by the development of (noncancerous) tumors or cysts in the uterus. In medical terms, this condition is called hydatidiform mole or trophoblastic disease. “Hydatidiform” means a fluid-filled sac or cyst, while “mole” means a mass of cells. Women who experience molar pregnancy show positive results on the test pack and still experience symptoms of pregnancy in general. However, what develops in the uterus is an abnormal growth of tissue typical of a tumor or cyst, not the fetus. That’s why this condition is also known as ” false pregnancy “. Hydatidiform mole is a life-threatening pregnancy complication. So , you need proper medical care and treatment in order to get pregnant again.
How Common Is Molar Pregnancy?
this condition of pregnancy occurs quite often. Statistics generally estimate that 1 in 500 pregnancies is a hydatidiform mole. The risk will increase at the beginning and end of a woman’s childbearing age. The risk is highest if you are pregnant under 16 years or pregnant near menopause (over 4o years). Hydatidiform mole cannot be saved because the fertilized egg does not make it into an embryo. The doctor will carry out special handling to take the abnormal tissue.
Signs And Symptoms Of Molar Pregnancy
- left lower back pain during pregnancy
- At first, a molar pregnancy is the same as general pregnancy symptoms. Over time, several other traits can emerge.
- Pelvic pain
- Nausea and vomiting that is worse than in normal pregnancy.
- Bleeding is accompanied by a collection of lumps-like grapes that come out of the vagina.
- Early preeclampsia in the early weeks of pregnancy.
- Increased levels of the hormone hCG .
- There were no signs of life in the fetus.
- The size of the uterus is not normal and does not match the gestational age.
- Hyperthyroidism (overactive thyroid gland and overproducing the hormone thyroxine).
- The appearance of ovarian cysts.
- The symptoms of hyperthyroid diseases, such as fatigue, nervousness, irregular heartbeat, and excessive sweating.
- Discharge from the vagina.
- Anemia in pregnant women.
After being detected positive for a molar pregnancy, these tissues will be removed by medical surgery until nothing is left in the uterus. This is done to prevent ongoing complications. Even if the symptoms you are experiencing are not detected as a false pregnancy, but you miscarry in the first 20 weeks with an unknown cause, this will often be indicated as a hydatidosis molar. Miscarriage within 20 weeks is common as a response by the body to end a problematic pregnancy.
When Should I See A Doctor?
|Molar Pregnancy on X-ray|
When you experience any signs of pregnancy, you should contact your doctor. Especially if you experience further symptoms of a molar pregnancy, such as: the rapid growth of the uterus (which can be seen from the mother’s growing belly in the short term), abnormally high blood pressure, the appearance of protein in the urine after 20 weeks of pregnancy, have anemia, hyperthyroidism, including feeling anxious/nervous, excessive sweating, or metabolism that is too fast. This pregnancy condition is practically fatal and requires immediate treatment.
Causes Of Molar Pregnancy.
1. Sperm does not fertilize the egg properly
Pregnancy initially occurs through the process of fertilization between the female egg and the male sperm cell. However, the abnormal fertilized egg develops into a tumor instead of a fetus. A molar pregnancy can also occur when the sperm does not properly fertilize the egg. Finally, a collection of cells that should be able to form the placenta turns into abnormal tissue. In this condition, fluid-filled tissue will grow to fill the space in the uterus instead of the fetus. These fluid-filled cells are called trophoblasts.
2. Chromosomal abnormalities
Another possible cause is a chromosomal abnormality. This condition can occur if the amount of genetic material in the fertilized egg is not correct. A normal human cell contains 23 pairs of chromosomes, one set from the mother and the other from the father.
The genetic structure of these chromosomes carries information to tell the body’s cells what to do. In molar pregnancies, there is an additional set of chromosomes that come from the father. When this happens, the fertilized egg is unable to survive and eventually dies several weeks into the pregnancy.
Molar pregnant type
1. Complete molar pregnancy
To form a fetus, normally it takes 46 complete chromosomes, namely 23 pairs of chromosomes from sperm and 23 pairs of chromosomes from eggs. Meanwhile, a complete complete molar pregnancy occurs when an egg without genetic content is fertilized by sperm. This condition results in the fetus not developing . However, in women with complete molar pregnancies , there is an error that occurs in the process of fertilization of the chromosomes. Chromosomes from egg and sperm cells fail to unite. As a result, there are only 23 pairs of chromosomes from the egg so the egg cannot survive and die. Even if the egg cell dies, the trophoblast (part of the placenta) will continue to grow and form a fluid-filled cyst. So, what is formed is a cyst (tumor), not a fetus called molar pregnancy.
2. Partial molar pregnancy
A partial false pregnancy occurs when two sperm with no chromosomes fertilize an egg. This can cause the fetus to grow and develop abnormally so that it cannot survive. It’s not just the chromosomes that fail to unite, the excess sperm count at conception can also be a cause of false pregnancies. The number of chromosomes that should be 46 pairs is more than the number needed. Although the fetus can be formed, abnormal trophoblast development can be an obstacle for the fetus to grow and develop. As a result, the baby can have birth defects .
Molar Pregnancy Risk Factors
Age at pregnancy. Pregnant women over 35 years or under 20 years are at higher risk. Have had previous molar pregnancies and/or miscarriages. Lack of intake of carotene, another form of vitamin A. Complications of molar pregnancy preeclampsia symptoms Molar pregnancies that are diagnosed early generally will not cause any health effects. However, if the diagnosis is late and not treated immediately, this pregnancy problem can cause the following complications
A molar pregnancy can cause bleeding from the vagina . Bleeding that comes out can be in the form of blood clots or watery brown liquid. The fluid that comes out is not completely blood, but also includes pieces of tumor tissue that can look like small grapes. Vaginal bleeding caused by a molar pregnancy usually starts between the 6th to 12th week of pregnancy.
The body of a woman who is pregnant with molars will process certain substances in the blood. These substances can increase blood pressure, then affect the work of the kidneys and sometimes even liver function. High blood pressure during pregnancy is a sign of preeclampsia.
3. Persistent GTD ( gestational trophoblastic disease )
Sometimes, after molar pregnancy tissue (molar pregnancy) is removed through the curette process , there may still be residual tissue that may be left in the uterine cavity. The remaining cells usually go away on their own within a few months. If not, this can lead to a condition called persistent GTD ( gestational trophoblastic disease ). Persistent GTD is characterized by an increase in the amount of hCG hormone, even after the curettage. Approximately 1 in 7 women with complete molar pregnancies and 1 in 200 partially molar pregnant women develop this complication.
4. Choriocarcinoma ( choriocarcinoma )
Choriocarcinoma is a type of cancer that forms in the lining of the uterus. Choriocarcinoma can occur after even a normal, healthy pregnancy. Most of the karyocarcinomas are associated with previous molar pregnancies.
Diagnosis Of Molar Pregnancy
Although it can be diagnosed as early as possible, this condition is usually detected at the 8th or 9th week of gestation via ultrasound. At that gestational age, the doctor will perform an ultrasound examination to detect the following conditions.
- Whether or not an actual embryo or fetus exists.
- No amniotic (amniotic) fluid or very low amniotic fluid .
- Cystic placenta that fills the uterus.
- Presence of ovarian cysts .
- There is a fetus, but growth is limited (in partial molar pregnancy).
- Other uterine examination using X- ray , CT scan , or magnetic resonance imaging (MRI) if it is suspected that the cancer may have spread to other areas of the body.
Treatment For Molar Pregnancy
curettage costs at the hospital Hydatidiform mole or molar pregnancy can be treated through some of these procedures.
1. Using drugs
If abnormal cells in the uterus grow large and cannot be removed with tools, the doctor will prescribe medication. Medicine will be given to make the uterus contract so that it can expel its contents through the vagina.
2. Dilation and curettage (D&C)
Dilation is a process to dilate the cervix because the mother’s cervix cannot open by itself. After opening, curettage or removing the tissue in the uterus is carried out to clean up the remaining molar pregnancy. Afterward, blood levels of the pregnancy hormone hCG will be measured to determine whether the hydatidiform mole (molar pregnancy) has completely removed.
This procedure is done by dissecting and lifting the uterus to be removed from the body. The main reason women have to undergo a hysterectomy is because they have health problems that require their uterus to be removed. Whichever solution the doctor recommends, maybe you will still need to undergo follow-up examinations for 6 months to 1 year.
4. Monitoring hCG levels
After the molar tissue is removed, the doctor will usually continue to take level measurements hCG level until it returns to normal. This test can be done by examining urine and blood. hCG is a hormone produced by the placenta during pregnancy. However, this hormone can also be produced when abnormal tissue grows in the uterus, such as in the case of a molar pregnancy. If the hCG level in the blood is still detected, the sign is that there is still molar tissue left in the uterus. In certain cases, the abnormal cells of molar pregnancy cannot be lost even though various treatments have been carried out after molar pregnancy. The condition of each woman is different, so the method of treating molar pregnancy can also be different in each case.
Home Care For Molar Pregnancy
Not infrequently, many couples grieve with this molar pregnancy condition. It takes a process to get back up from the depression of losing a child and trying to get pregnant again. During the process of cell cleaning, medication, therapy, and the period of waiting to get pregnant again, women and their partners can be exposed to stress. It’s important that you don’t feel this disappointment, sadness, and anxiety alone. It should also be instilled that most molar pregnant patients who are successfully treated can give birth to healthy babies without any problems in the future. Remember that a molar pregnancy has no impact on your future fertility. Most women have healthy pregnancies afterward. To be able to deal with sadness caused by this condition, you can find a support group that has the same pregnancy problems as you. Later, you and your support group or community can share stories and try to recover together. If the feeling of disappointment is unbearable, you can contact a psychologist or psychiatrist who can help restore your emotional state.
Preventions Of Molar Pregnancy Cause Of Preeclampsia
1. Give pause for a year before trying to get pregnant again
The remnants of molar pregnancy tissue will increase levels of the hormone hCG, aka the pregnancy hormone. If you get pregnant before a year’s gap, it will be difficult for your doctor to detect whether the increase in hCG levels is caused by a normal pregnancy or comes from remnants of abnormal tissue from a previous molar pregnancy. If you want to have a successful normal pregnancy, it’s best to wait a year before trying to get pregnant again.Your doctor will monitor your hCG level once a month for one year. This is done to ensure that there is no remaining tissue that does not grow as a result of a failed pregnancy.
2. Avoid getting pregnant at old age
Apart from being full of pregnancy risks, getting pregnant at an old age (over 40 years) increases the risk of recurrent molar pregnancies. Before deciding to get pregnant or have another child at an age that is no longer young, you should first consult with your obstetrician.
Molar pregnancy ( molar pregnancy ) is a pregnancy complication characterized by the formation of benign tissue or cysts in the uterus. This condition can be treated with medication, dilation and curettage, hCG monitoring, and hysterectomy.