Vesicular molar pregnancy: Symptoms, Causes and Treatment

What is a vesicular mole?

A vesicular mole is also called Hydatidiform mole, it is a complication in pregnancy characterized by an abnormal fertilized egg or growth of trophoblasts cells in placenta. It will lead to molar pregnancy.

Molar pregnancy are of two types: complete molar pregnancy and partial molar pregnancy. Difference between complete and partial mole is: In complete molar pregnancy, placenta is in the form of fluid-filled cysts and it is swollen. Fetal tissue can not be formed during this condition. But, in partial molar pregnancy there are some normal and some abnormal placenta tissues. There are chances of formation of a fetus as well, but it is very rare that the fetus will be able to survive. Usually women have to go for miscarriage during early pregnancy. It can also cause a form of cancer, which requires early treatment.

Signs and symptoms of molar pregnancy

A molar pregnancy is somewhat similar to normal pregnancy in early stages, but it has some specific signs and symptoms to differentiate it from normal pregnancy.

  • Bright red to dark brown bleeding from vagina during the first 3 months of pregnancy.

  • Pelvic floor muscle contraction or pain

  • Passage of grape like cysts

  • Severe morning sickness and vomiting

If you are facing the above mentioned issues or symptoms, kindly consult with your doctor. They will be able to confirm if it is molar pregnancy or any other condition. They may detect some other molar pregnancy symptoms, such as:

  • Large uterus in early stage as compared to normal pregnancy.

  • High blood pressure and protein in urine, which is caused due to preeclampsia in the second trimester of pregnancy.

  • Hyperthyroidism or overactive thyroid

  • Anemia

  • Ovarian cysts

What causes molar pregnancy?

There are 23 pairs of chromosomes in each human cell. Each pair consists of one chromosome from father and one from mother. Fertilization in normal pregnancy is the union of one egg and sperm, meaning each pair of chromosomes will consist one chromosome from father and one from mother. Molar pregnancy causes includes:

In a complete molar pregnancy all the genetics is from father because an empty egg is fertilized by one or more sperms. In this condition, father’s chromosomes are duplicated and there are no remains of chromosomes from mother.

In partial molar pregnancy, there is a fertilized egg but along with mother chromosomes there are two chromosomes of father in each pair. In this condition, the embryo will consist of 69 chromosomes instead of 46. It will cause an extra copy of father’s genetics as two sperms are fertilizing an egg.

Risk factors in molar pregnancy

  • Age factor: Molar pregnancy can be seen in women who are older than age 35 or younger than age 20.

  • Repeated molar pregnancy: There are less chances involved of successful pregnancy after mole pregnancy. 1 out of 100 diagnosed women face repeated molar pregnancy.

What are the complications involved?

Persistent gestational trophoblastic neoplasia (GTN) is a molar pregnancy complication, under this the molar tissue may continue to grow even after it has been removed. It can be seen in 15-20% of complete molar pregnancies and 5% of partial molar pregnancies.

Molar pregnancy gestational trophoblastic disease can cause high levels of human chorionic gonadotropin (HCG), it is a pregnancy hormone and vaginal bleeding due to an invasive hydatidiform mole formed into the middle layer of the uterine wall.

GTN can be treated using chemotherapy or by removing the uterus. It can happen in rare cases that Choriocarcinoma, a cancerous form of GTN spreads to other organs as well. This complication can be seen more in complete molar pregnancy then the partial molar pregnancy. It can be treated using multiple cancer drugs.

Molar pregnancy treatment

A molar pregnancy is not like a normal pregnancy. The abnormal placental tissues have to be removed to prevent further complications. Treatment can consist of the following steps:

  • Dilation & curettage (D&C): This is the process of removing the molar tissues from your uterus. In this process, your doctor will position you on a table, on your back and legs in stirrups, then he will dilate your cervix and then with the help of a vacuum device will remove uterine tissues.

  • Hysterectomy: This means removing the uterus, which is performed in case of increased risk of GTN. It is a very rare case and can be done if there’s no desire for more kids.

  • Monitoring HCG levels: Your HCG levels will be monitored frequently until it is normal. Otherwise, additional treatments are required. HCG levels should not increase as it will cause increase in molar tissue. Doctors recommend to wait for 1 year approx for the next pregnancy because pregnancy will lead to increased HCG levels.

How to prevent another molar pregnancy?

Consult your doctor if you’ve had a molar pregnancy earlier. Totally avoid getting pregnant right after molar pregnancy, your doctor will also recommend you to wait for 6 months to 1 year before you conceive again. It will help in lowering the risk of recurrence. Your doctor may continuously monitor your condition by doing regular ultrasounds. Even can recommend prenatal genetic testing.