You can thank the hormone hCG for making that “+” sign appear on a pregnancy test. When hCG levels soar, you might suspect a twin pregnancy. But sometimes they skyrocket due to something more somber — a molar pregnancy.
Read on to find out:
- What molar pregnancy is, and how to know if you have it
- How to treat molar pregnancy with a natural approach
- Plus, how to heal from a molar pregnancy and move forward
What Is Molar Pregnancy?
Molar pregnancy is a rare, yet serious condition that results in an abnormal placenta and fetus, or no fetus at all. Rather than form correctly, the placenta develops cysts that prevent food and oxygen from reaching the baby.
Types of Molar Pregnancy
According to Mayo Clinic, there are two main kinds of molar pregnancy, partial and complete.
- Partial molar pregnancy: There is a fetus, but birth defects range from mild to severe. Unfortunately, the pregnancy almost always ends in miscarriage.
- Complete molar pregnancy: There is no fetus, only an abnormal placenta. Sadly, the pregnancy is never viable, since there is never a fetus.
Is Molar Pregnancy Cancerous?
According to the Mayo Clinic, in rare cases, a molar pregnancy turns into Persistent Gestational Trophoblastic Neoplasia (GTN), a condition where molar tissue (referred to as a mole) continues to grow even after the molar pregnancy ends.
When this happens, a mole penetrates deep into the uterine wall, causing bleeding through the vagina. In about 0.1 percent of cases the GTN becomes cancerous and spreads to other organs
How Common Are Molar Pregnancies?
This condition is rare and occurs in about 1 in 1,500 pregnancies.
That said, According to the Mayo Clinic, the following groups of women have an increased risk:
- Asian and African women
- Mexican, Southeast Asian, and Filipino women
- Women younger than 20 or older than 35
- Women who have had more than two miscarriages
What Causes Molar Pregnancy?
In a normal pregnancy, mom and dad both donate one set of chromosomes to baby. But genetic mixups can occur when two sperm fertilize one egg or because of genetic defects in the egg. (source)
- Partial molar pregnancy: There are three sets of chromosomes—two sets from dad, plus mom’s set.
- Complete molar pregnancy: The egg receives two chromosomes from dad, but none from mom.
What causes these genetic abnormalities?
While researchers aren’t 100 percent sure, they suspect environmental toxins may play a role.
- This study found that men who did physical labor and came in contact with dirt were four times more likely to father a molar pregnancy.
- A 2011 study found that 85 percent of mothers with a molar pregnancy lived in a farming area, where pesticides were likely used.
Interesting to note: Morocco has one of the highest rates of molar pregnancy at 1 in 400, compared to the global average of 1 in 1,500. This country continues to use large amounts of organochlorine and organophosphate pesticides, like DDT.
It’s impossible to control all of the environmental toxins we’re exposed to, but these lifestyle choices can help:
- Eat locally grown and pesticide-free organic produce as much as possible
- Avoid going outside when farmers or neighbors are spraying pesticides
- Use a homemade weed spray with ingredients like vinegar and salt
Symptoms of Molar Pregnancy
Remember, this condition is extremely rare, so the odds are most certainly in your favor. And since molar pregnancy almost always ends in miscarriage, symptoms are usually similar to typical miscarriage signs and many women may never even suspect molar pregnancy.
That said, the most common symptoms used to differentiate molar pregnancy are abnormally high hCG levels and a uterus that’s larger than it should be. (source) But most of these symptoms won’t be immediately clear, unless you’ve visited your healthcare provider to track hCG levels and uterine growth.
In a molar pregnancy:
- 25 percent of women have an enlarged uterus
- 20 percent of women have pain from cysts (pressure/pain in pelvis area)
- 10 percent of women have grape-like sacs that come out of the vagina
- 10 percent of women have severe nausea and vomiting
- 5 percent of women have hypothyroid
- 5 percent of women have preeclampsia
Other symptoms can include:
- Dark brown to bright red vaginal bleeding in the first trimester
- Small uterus (because there’s no baby in it)
- High blood pressure
- Severely low iron (anemia) or other nutrients
- Absence of fetus
- No fetal movement or heartbeat
- Lack of amniotic fluid
- A thick, cyst-filled uterus
- Enlarged ovaries
How Is a Molar Pregnancy Diagnosed?
hCG Blood Test
If your healthcare provider suspects a molar pregnancy, they will test your hCG levels.
- In a partial molar pregnancy, hCG levels are generally normal.
- In a complete molar pregnancy, hCG levels are generally greater than 100,000 mIU/mL. (source)
An ultrasound of your uterus can help confirm suspicions of a molar pregnancy. (source)
- Your healthcare provider will perform a transvaginal ultrasound as early as 8 weeks gestation. (A regular ultrasound isn’t as accurate in early pregnancy, since the placenta and baby (if there is one) are closer to the cervix.)
- The healthcare provider will look for a uterine size that is greater than expected for gestational age and/or an intrauterine mass containing grape-like cysts. (source)
- Complete blood cell count
- Creatinine and electrolytes
- Liver, kidney, and thyroid function
What Happens if Molar Pregnancy is Confirmed?
If this condition is confirmed, your provider will do more testing (x-ray, MRI, and blood tests) to see if the mole has spread to areas outside the uterus and determine the best treatment options for you.
- Because of the presence of abnormal tissue that can metastasize, molar pregnancies are generally removed through a D&C, or dilation and curettage. (source)
- In some cases, your healthcare provider may prescribe a pill called misoprostol that can help your body expel the tissue more naturally.
What If It’s Not a Molar Pregnancy?
Since this is a relatively rare condition, your symptoms may be due to other pregnancy complications, like:
- Ectopic pregnancy: Also relatively rare condition, this condition occurs when the fertilized egg doesn’t make it to the uterus, usually lodging in the fallopian tube instead. Ectopic pregnancy can cause pain near the ovaries and/or pelvis, vaginal bleeding, and low blood pressure.
- Miscarriage: A miscarriage can occur for many reasons, and is estimated to happen in about 25 percent of pregnancies. Brown or bright red vaginal bleeding, passing clots, and contractions are common signs of miscarriage.
- Implantation bleeding: When the fertilized egg attaches to the uterine wall there can be some spotting, called implantation bleeding. This is normal and doesn’t mean anything is necessarily wrong.
- Period: Maybe you thought you were pregnant, but your period was just late this month. Your monthly period could be what’s causing the bloating, cramps, and bleeding.
- Subchorionic hemorrhage: This occurs when blood gathers in the folds next to the placenta, causing some bleeding and/or clots. Subchorionic hemorrhage is usually not serious, but still needs to be addressed.
- Vaginal irritation: When vaginal tissue becomes irritated (like not using lube during sex), it can cause spotting, bleeding, and some pain.
- Cervical Polyps or Fibroids: These growths can happen in the uterine lining or cervix, causing bleeding and discomfort.
- Cervicitis: Inflammation of the cervix can sometimes cause bleeding and pain.
Treatment for Molar Pregnancy
Testing will determine the treatment plan, but it almost always includes surgery to remove the tumor (aka mole).
Mole removal typically involves dilating the cervix, then removing the tissue. After treatment, the vast majority of women—90 percent!—won’t need any further treatment after the mole is removed. (source)
When Does Molar Pregnancy Require Further Treatment?
Persistent Gestational Trophoblastic Neoplasia (GTN), or molar tissue that continues to grow after removal, occurs in 15-20 percent of complete molar pregnancy cases and up to 5 percent of partial molar pregnancies. High hCG levels after tissue removal usually indicate cancer. In these cases, chemotherapy is the standard treatment, but not always necessary.
The good news? Chemotherapy or hysterectomy for GTN has a cure rate of 100 percent. (source) Some researchers say that GTN shouldn’t even be called cancer, because of this!
Can you get pregnant after chemo?
If you and your doctor decide chemotherapy is the best option for you, then precautions need to be had before trying to conceive again. Chemotherapy damages ovarian function and can damage a developing egg, so pregnancy is not recommended for one full year after chemo treatment.
Trying to Get Pregnant After Molar Pregnancy
Your doctor will want to monitor your hCG levels for 6-12 months to make sure there’s no more molar tissue growth.
Since hCG levels naturally increase during pregnancy, you should wait 6-12 months before getting pregnant again. This way your doctor will have a clearer picture of what’s going on with the molar tissue. (source)
You can take comfort knowing the odds of another molar pregnancy are extremely slim:
Only 1 percent of women with molar pregnancy will have another one (source).
Healing After Molar Pregnancy
Although a molar pregnancy is abnormal tissue growth and not a viable baby, it’s normal to feel a sense of loss.
Grief, anger, and depression are some of the emotions you might feel. It’s important to take care of your physical, mental, and emotional health during this time. Here are some ways to care for yourself and heal after a pregnancy loss.
How About You?
Have you ever experienced molar pregnancy or thought you might have a molar pregnancy? Let us know about it in the comments below.