This condition is also known as molar pregnancy. It is an abnormal growth inside the uterus caused by a problem during fertilization. This growth is supposed to develop into a placenta which normally functions to nourish the fetus during pregnancy. That is why the mass is made up usually of placental materials (complete type) or placental tissues and an abnormal fetus (partial type). The patient thinks she is really pregnant because there is also production of the pregnancy hormone called HCG. The precise cause is not yet fully understood. The condition is associated with egg defects and uterine abnormalities. It is common in women more than 40 years old and in those with prior molar pregnancy. The patient manifests vaginal spotting or vaginal bleeding, nausea and vomiting. abnormal size of the uterus with respect to the stage of pregnancy. It can be either too big or too small than what is expected. There can also be heat intolerance, rapid heartbeat, nervousness, tremors in the outstretched fingers, unexplained weight loss which are all signs of hyperthyroidism. Symptoms similar to preeclampsia (presence of protein in the urine, high blood pressure, swelling in legs, ankles, and feet) but occuring in the first trimester of pregnancy almost always indicates presence of H. mole. Ultrasound examination reveals the presence of “cluster of grapes” appearance of placental tissue indicating abnormality of the placenta. Management is done by performing a D&C (dilation and curettage). For older women or those who do not require future pregnancy, hysterectomy or removal of the entire uterus is an option. After any of these procedures, monitoring the HCG level in the serum is done regularly in order that recurrence can be monitored. Follow up visits of the patient to the doctor is a must and the patient is advised to have no pregnancy for at least one year following the procedure. Once recurrence is noted then the patient is advised to have chemotherapy. There is usually a good outcome after treatment. A very low percentage develop into choriocarcinoma. Most cases of H. mole occur after miscarriage, some after an ectopic pregnancy. If a woman wants to know whether she has a molar pregnancy, a visit to a doctor must be done to know her HCG level. |
