Molar pregnancy is a type of pathology in which the fetus stops developing for some reason or is completely absent. Doctors call a fertilized egg, which cannot become a full-fledged embryo, “pray,” and this is the name of the violation. Such an abnormality of pregnancy occurs in one woman out of one and a half thousand. The main provoking factors include the mother's age up to twenty years or over thirty-five, as well as a history of chorionadenoma.
Pathology development mechanisms
Doctors distinguish two types of molar pregnancy, which differ in their developmental mechanisms. The embryo may not develop, but placental tissue is formed. As a rule, this happens if the woman’s eggs do not have enough maternal chromosomes (the chromosome is either lost or is unusable). The germ cell is fertilized by one or two sperm. That is, a fertilized egg contains only the father's chromosomes. The fetus does not develop, and the placenta degenerates into a cyst. In this case, ultrasound diagnostics will show that there is no embryo, but only placental tissue. This is a complete molar pregnancy.
With a partial mole, the mother's chromosome set is normal - 23 pairs of chromosomes. But on the father’s side, there is a double number of chromosomes, that is 46. This happens if the egg is simultaneously fertilized by two sperm and pathology develops, or if duplication of the chromosome set occurred in one sperm. In this case, the placenta is formed from pathological and normal tissue. The embryo begins to develop, but freezes, because it is not viable. With partial pathology, the doctor can detect an ultrasound embryo, amniotic fluid and fetal membranes.
Causes of molar pregnancy
The main cause of the pathology is problems in the transmission of genetic information during conception. This is a pretty rare occurrence. The following factors increase the likelihood of anomalies:
a woman under the age of twenty and over thirty-five;
the presence in the history of certain diseases (in particular, chorionadenomas).
Risk factors have not yet been identified. There is a version that molar pregnancy can cause a deficiency of carotene (the pigment found in red and orange vegetables and fruits), which in the human body turns into vitamin A. Women in Southeast Asia (especially Vietnamese and Korean) have a slightly increased risk of pathology. There are some dietary theories why it is in Asian women that the risks are increased.
After a molar pregnancy, the probability of occurrence of which is on average 1-2%, the chances of the next normal are high. In two previous pregnancies with impaired transmission of genetic information, the likelihood of conceive and bear a healthy baby is reduced by 15-20%.
The main symptoms of pathology
In the early stages, molar pregnancy is no different from physiologically normal. Minor spotting, nausea and vomiting, spasmodic pains in the lower abdomen, and an increase in the abdomen may appear. With pathology, the uterus usually increases faster than it does in women with normal pregnancy. Spotting can turn into severe bleeding. All these alarming symptoms usually appear at 8-9 weeks of gestation, but can also occur in the period from the 6th to the 12th.
In the presence of bloody discharge in early pregnancy and with abdominal pain, you should immediately consult a gynecologist. The doctor will prescribe a blood test to determine the level of hCG, as well as refer the patient for an ultrasound scan.
In molar pregnancy, the hCG rate is significantly higher than that which corresponds to the expected term. The active release of the hormone causes the rapidly forming tissue of the placenta. With a partial mole, the hCG level can be normal or slightly increased, which complicates the diagnosis. In this case, specialists usually suspect oncology. On ultrasound, multiple cysts are detected or the embryo is not detected at all.
Treatment of pathological pregnancy
The only outcome of the pathology is the removal of an undeveloped embryo from the uterus. If the diagnosis is confirmed at home, nothing can be helped to the woman, the treatment is carried out only in the hospital. If there are no complications and a pathological pregnancy was diagnosed in time (8-9 weeks - no more), then on the same day a woman can go home. The embryo is removed by curettage or vacuum extraction. During the procedures, pathological material is removed from the uterine cavity.
Curettage
Curettage of the uterine cavity today is carried out in two ways: this is either hysteroscopy or separate cleaning. The first option is safer for women and more convenient. In the process, a large device is used, which is inserted into the internal organ and allows you to see the course of the entire treatment process. Traditionally, curettage is performed “blindly”, which increases the risk of complications and disorders associated with damage to the internal genital organs.
The procedure does not guarantee that the pathological material will not remain in the internal organs of the woman’s reproductive system. 11% of patients experience complications associated with incomplete removal of a frozen embryo or empty fetal egg. With a full molar pregnancy, this indicator ranges from 18 to 29%. This deviation is called persistent trophoblastic neoplasia. Pathology is treated by chemotherapy. In rare cases, it can degenerate into a malignant neoplasm - this is the most dangerous consequence of a molar pregnancy.
Pathological vacuum extraction
During vacuum extraction, the apparatus is inserted through the vagina into the uterine cavity, negative pressure is created, and the fetus or other pathological inclusions are removed. The procedure is carried out only for periods (up to six weeks). For up to twelve weeks, the method can be used with the necessary equipment and after special training. The material extracted from the uterus after the procedure must be sent for examination in order to confirm the abnormality (histological and genetic examination).
Planning your next pregnancy
It is possible to plan the next pregnancy after an abnormal one year later. This will enable the hCG indices to fall to a normal level, which will reduce the risk of developing pathology. If a woman becomes pregnant earlier, then it will be more difficult for a gynecologist to observe the patient in terms of hCG. It will not be known for sure whether the pregnancy is proceeding normally. To avoid negative consequences, it is better to protect yourself and wait for a better time for conception.