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CORDILLERA CAREER DEVELOPMENT COLLEGE

COLLEGE OF HEALTH EDUCATION
BACHELOR OF SCIENCE IN NURSING

A MOLAR PREGNANCY

- also known as hydatidiform mole, is a rare complication of pregnancy characterized by the

abnormal growth of trophoblasts, the cells that normally develop into the placenta.

TWO TYPES:

1. Complete molar pregnancy- the placental tissue is abnormal and swollen and appears to
form fluid-filled cysts. There's also no formation of fetal tissue.
2. Partial molar pregnancy- there may be normal placental tissue along with abnormally
forming placental tissue. There may also be formation of a fetus, but the fetus is not able
to survive, and is usually miscarried early in the pregnancy.

SIGNS AND SYMPTOMS:

 Dark brown to bright red vaginal bleeding during the first trimester
 Severe nausea and vomiting
 Sometimes vaginal passage of grapelike cysts
 Pelvic pressure or pain

OTHER SIGNS:

NCM-112 GYNE-CASE ANALYSIS PREPARED BY: MG PARAN

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 Rapid uterine growth — the uterus is too large for the stage of pregnancy
 High blood pressure
 Preeclampsia — a condition that causes high blood pressure and protein in the urine after
20 weeks of pregnancy
 Ovarian cysts
 Anemia
 Overactive thyroid (hyperthyroidism)

CAUSE:

A molar pregnancy is caused by an abnormally fertilized egg. Human cells normally contain 23
pairs of chromosomes. One chromosome in each pair comes from the father, the other from the
mother.

RISK FACTORS:

Approximately 1 in every 1,000 pregnancies is diagnosed as a molar pregnancy. Various factors

are associated with molar pregnancy, including:

 Maternal age. A molar pregnancy is more likely in women older than age 35 or
younger than age 20.

 Previous molar pregnancy. If you've had one molar pregnancy, you're more likely
to have another. A repeat molar pregnancy happens, on average, in 1 out of every
100 women.

COMPLICATIONS:

-molar tissue may remain and continue to grow which is the persistent gestational trophoblastic
neoplasia (GTN).

One sign of persistent GTN is a high level of human chorionic gonadotropin (HCG) — a

pregnancy hormone — after the molar pregnancy has been removed. In some cases, an invasive
hydatidiform mole penetrates deep into the middle layer of the uterine wall, which causes
vaginal bleeding.

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Rarely, a cancerous form of GTN known as choriocarcinoma develops and spreads to other

organs.

PREVENTIONS:

 talk to your doctor or pregnancy care provider before conceiving again.

 ultrasounds to monitor your condition and offer reassurance of normal development
 prenatal genetic testing, which can be used to diagnose a molar pregnancy.
 Blood test

An ultrasound of a complete molar pregnancy — which can be detected as early as eight or nine
weeks of pregnancy — may show:

 No embryo or fetus

 No amniotic fluid

 A thick cystic placenta nearly filling the uterus

 Ovarian cysts

An ultrasound of a partial molar pregnancy may show:

 A fetus that's unexpectedly small for gestational age

 Low amniotic fluid

 Placenta that appears abnormal

If your health care provider detects a molar pregnancy, he or she may check for other medical
problems, including:

 Preeclampsia

 Hyperthyroidism

 Anemia

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TREATMENTS:

 Dilation and curettage (D&C)- removal of the molar tissue from your uterus
During the procedure, you'll receive a local or general anesthetic and be positioned
on the operating room table on your back with your legs in stirrups. Your doctor
will insert a speculum into your vagina, as in a pelvic exam, to see your cervix. He
or she will then dilate your cervix and remove uterine tissue with a vacuum device.

 Hysterectomy. Rarely, if there is increased risk of gestational trophoblastic

neoplasia (GTN) and there's no desire for future pregnancies, the uterus may be
removed (hysterectomy).

 HCG monitoring. After the molar tissue is removed, your doctor will repeat

measurements of your HCG level until it returns to normal. If you continue to
have HCG in your blood, you may need additional treatment.

References:

1. Ferri FF. Molar pregnancy. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa.: Elsevier;
2018. https://www.clinicalkey.com. Accessed Sept. 8, 2017.

2. Rumack CM, et al., eds. The first trimester. In: Diagnostic Ultrasound. 5th ed.
Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Sept. 8, 2017.

3. Walls RM, et al., eds. Acute complications of pregnancy. In: Rosen's Emergency
Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018.
https://www.clinicalkey.com. Accessed Sept. 8, 2017.
4. Babymed.com
5. Book: Mayo Clinic Guide to a Healthy Pregnancy

NCM-112 GYNE-CASE ANALYSIS PREPARED BY: MG PARAN