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Complications and symptoms

How Long does Morning Sickness last? Morning Sickness Symptoms

Table of Contents

What is Morning sickness

Morning sickness is a complaint that usually occurs during pregnancy and includes symptoms such as vomiting and nausea. It does not necessarily occur in the morning, but at any time of the day or night. It is most common in pregnancy during the first trimester but, in a few cases, it may occur during the whole pregnancy period. It is usually the first sign a woman observes at the start of pregnancy, distressing more than 80% of women during their pregnancy period. Women taking hormone replacement therapy or hormonal contraceptives may also experience morning sickness.

Morning sickness can be relieved by home remedies such as sipping ginger ale, over-the-counter medications, and taking healthy snacks throughout the day. In rare cases, morning sickness takes a much more serious form known as hyperemesis gravidarum. In hyperemesis gravidarum, vomiting and nausea result in severe dehydration and weight loss, which may be more than 5 percent of the weight of the woman before the start of pregnancy. If it reaches emergency level, hyperemesis gravidarum may require hospitalization during pregnancy to receive intravenous fluids to combat dehydration, medications, and sometimes a feeding tube[1].

Morning sickness is an uncomfortable and irritating condition, but it poses no health risk to the mother or fetus. It is a physiological process of pregnancy and some researches have proven that it is a sign of a normal and healthy pregnancy.

Some studies show that pregnancies in which morning sickness occurs have less risk of stillbirths and miscarriages[2].

What causes morning sickness?

The common cause of morning sickness in pregnancy is a change in the levels of hormones in the body. The most common hormones include progesterone, estrogen, and human chorionic gonadotropin (hCG). Other causes may include changes in blood sugar levels and sense of smell.

Estrogen levels increase by approximately one hundred percent in pregnant women as compared to non-pregnant women. However, there is no evidence of a difference in the levels of estrogen circulating in pregnant women who have morning sickness and those who do not have morning sickness. Additionally, one of the main roles of increased progesterone levels during pregnancy is to relax the muscles of the uterus to prevent preterm labor and early childbirth. An increase in progesterone levels may also relax the muscles in the stomach and bowel, causing more acid secretion from the stomach cells and acid reflux. HCG is produced by the developing embryo and placenta at different stages of pregnancy. Some experts propose that morning sickness has an association with HCG.

Hypoglycemia, caused by increased transport of glucose from the mother’s body to the fetus via the placenta, may cause decreased energy levels. A decrease in energy levels can also cause nausea and vomiting in pregnancy. Pregnancy may cause an increase in sensitivity to odors that may overstimulate normal nausea stimulus[3].

Causes of Morning Sickness Other Than Pregnancy:

  • Insomnia and fatigue may disturb sleep patterns and change the neuroendocrine response, resulting in vomiting and nausea.
  • If a person sleeps for more than 12 hours without having a meal before sleep, low levels of glucose in the body can make you feel weak, nauseous, and dizzy upon waking.
  • Any health condition that causes increased acidity in the stomach or acid reflux to the esophagus may cause symptoms similar to morning sickness.
  • Sinus congestion puts pressure on the inner part of the ear, causing dizziness, nausea, vomiting, and stomach upset.
  • When post-nasal drip drains mucus from the sinuses to the throat and stomach, it can cause symptoms similar to morning sickness[4].
  • Due to emotional disturbances like anxiety, stress, and excitement, you may feel nausea.
  • Vomiting and nausea in the morning can be caused by excessive alcohol consumption the previous night. Alcohol can also cause hypoglycemia and dehydration.
  • Morning sickness may be caused by a food allergy or intolerance. Overeating can also cause nausea and vomiting.
  • A stomach disorder known as gastroparesis may also result in nausea. It is a condition in which the muscles in the wall of the stomach become weak, obstructing the transport of food to the intestines.
  • Morning sickness may occur in the case of gallstones. These are formed due to high cholesterol levels which accumulate and harden in the bile ducts to form stones. It attaches gallbladder to the intestine via tubes that can cause pain and nausea[5].
  • Vomiting and nausea are side effects of many medications that include opioids, antibiotics, and some other drugs. Drugs used in chemotherapy also stimulate the part of your brain that controls nausea and vomiting. Occasionally, such medications disturb the cells in the lining of the intestine and stomach and may result in vomiting and nausea[6].

Symptoms of Morning Sickness:

Symptoms of morning sickness typically include vomiting and nausea, commonly during the early months of pregnancy. In some cases, symptoms of morning sickness may become severe and may also be associated with other symptoms, including:

  • Severe nausea, vomiting, or both
  • Decreased urinary output with dark-colored urine
  • Dizziness or fainting while standing up
  • Unable to keep liquids down
  • Palpitations
  • Vomiting blood

Usually, symptoms of morning sickness improve after twelve weeks of pregnancy, but in some cases may persist for the whole duration of the pregnancy[7]

How long does morning sickness last?

Morning sickness starts in the 6th week of pregnancy and lasts until about the 12th week. Symptoms of morning sickness are at a peak between 8 to 10 weeks. According to many studies, almost 50 percent of pregnant women feel free from morning sickness at about the 14th week of pregnancy or at the beginning of the second trimester. The same studies also revealed that 90 percent of pregnant women had settled morning sickness by 22 weeks. Additionally, pregnant women who experience nausea and vomiting during the eighth week have a decreased risk of miscarriage by about 50 percent.

Morning sickness is not restricted to the morning only; it may also occur throughout the whole day or night. Only two percent of pregnant women feel morning sickness only in the morning. However, if you went to sleep hungry, there is an increased risk of vomiting and nausea in the morning after waking up. Some health professionals have changed the name of morning sickness and now call it NVP, or nausea and vomiting during pregnancy[8].

If morning sickness does not last a typical amount of time or symptoms become severe, it may be a complication of morning sickness known as hyperemesis gravidarum. This usually occurs in about 0.5 to 2 percent of pregnancies. This condition is the second most common reason for hospitalization in pregnant women. Most cases of hyperemesis gravidarum recover at the 20th week of pregnancy, but 22 percent of cases resolve after the termination of pregnancy.

Women who suffer from hyperemesis gravidarum once have increased risk in future pregnancies. Other risk factors include:

  • Family history of hyperemesis gravidarum
  • Pregnancy at a younger age
  • At first pregnancy, the risk is more
  • Twin or multiple pregnancies
  • Obese women[9]

How to Diagnose Morning Sickness

If you have symptoms of morning sickness, your physician may ask for some investigations to confirm the diagnosis. In the case of pregnant women, the doctor may order some tests to rule out any maternal or fetal disorder. All the investigation that may be required include:

  • Urine Tests

    Urine tests help to determine dehydration, normal amounts of specific hormones that are secreted in urine during pregnancy, and creatinine levels.
  • Blood  Tests

    Blood chemistry tests include a complete blood count and comprehensive metabolic panel (Chem-20). These tests will check out the electrolytes in the blood, malnourishment, dehydration, deficiency of certain vitamins, and anemia[10].
  • Ultrasound

    Ultrasound is used to investigate the normal growth and development of your baby with the help of images produced by sound waves.
  • What are the best remedies for morning sickness?

    Morning sickness can be relieved with lifestyle measures and home remedies. Medical treatment is also available for treating morning sickness.

    Lifestyle and Home Remedies:

    • Food items that are low in fat and high in protein can help to prevent or treat symptoms of morning sickness. Pregnant women should avoid eating spicy, fatty, and greasy foods. Eat foods that are easy to digest and do not harm the digestive tract. Food items such as rice, bananas, applesauce, and toast are high in energy and easy to digest. Foods containing ginger, such as ginger lollipops and other salty foods, can also prevent nausea.[11]

    • Eat a piece of dry toast or a few soda crackers after waking up in the morning. Eat small meals with plenty of snack foods throughout the day. Larger meals are not helpful during pregnancy because they cause acidity and nausea. The empty stomach worsens the symptoms of morning sickness; that is why frequent snacking is preferred during pregnancy.

    • High fluid intake can help in pregnant women with mild or severe morning sickness and in pregnant women with dehydration as a complication of morning sickness. Sipping ginger ale and water are good for reducing symptoms. During pregnancy, more than six cups of non-caffeinated fluids are helpful.

    • Avoid smells and foods that increase symptoms of morning illness. Certain smells and foods trigger nausea in pregnant women.

    • Keep the windows or doors open at home or the workplace for fresh air. Go outdoors for a walk in the morning or evening.

    • Prenatal vitamins are essential during pregnancy. If a woman feels nauseous or queasy, she should take vitamins with a snack or at night before going to bed. If these measures do not help to prevent the symptoms, ask your doctor for other ways to fulfill your dietary needs.

    • Use mouthwash and properly clean your mouth after vomiting. The acid produced in the stomach can be damaging to the teeth. Baking soda mixed in water is a good choice because it neutralizes the acid and protects the enamel of your teeth[12].

    Alternative medicine

    Several alternative remedies can help protect you against morning sickness, including:

    • Wristbands are available without prescriptions and may prove helpful to women with morning sickness due to their acupressure properties.

    • Acupuncture is another way to treat morning sickness in some pregnant women. In this procedure, a trained practitioner uses needles that are inserted into the skin – or deeper – and provide relief from symptoms of morning sickness.

    • Herbal ginger supplements help to lessen nausea and vomiting in some women. Most research proposes that ginger is safe for consumption during pregnancy, but according to some studies, ginger may affect fetal sex hormones.

    • In some women, morning sickness can be relieved by hypnosis. Aromatherapy can also help some women deal with morning sickness[13].

    Medical Treatment:

    In mild cases, medical treatment is not required. However, in case of severe symptoms or extreme discomfort, your doctor may prescribe B-6 supplements (pyridoxine), ginger, and over-the-counter medications such as doxylamine. Anti-nausea drugs such as ondansetron and promethazine are safe to use during pregnancy and commonly prescribed by the doctors.

    Diclegis is an FDA-approved medication for use in pregnancy. One clinical study determined that Diclegis relieved nausea completely in more than 40 percent of pregnant women with morning sickness. Another trial concluded that about 70 percent of women showed improvements in morning sickness symptom[14].

    In moderate or severe vomiting and nausea, dehydration may occur causing the loss of electrolytes such as potassium and sodium. In such cases, oral or intravenous fluids, along with prescription drugs, may have a significant role in relieving the symptoms.

    Your doctor will ask about how many times you have vomited, the frequency of nausea, whether you have consumed extra fluids, and whether you have practiced home remedies. Your doctor will recommend medications for symptoms of morning sickness that are safe in pregnancy.

    Also, consult your physician before taking any supplement or over-the-counter medications during pregnancy. If you have hyperemesis gravidarum, you may need emergency treatment or hospitalization. Treatment involves intravenous fluids and anti-nausea medications[15].

    Best Foods for Dealing With Morning Sickness

    Every pregnant woman has different reactions to different foods. But when it comes to the health and safety of the fetus as well as the mother, there are a few things you need to remember when consuming food that will not only ensure good health but also keep your morning sickness at bay.

    • Go for easy to digest foods
      When feeling sick, look for light foods such as avocado, ripe bananas, applesauce and toasts.

    • Drink fluids
      Try nutritious fluids such as herbal teas, almond milk, soups, smoothies and lemon water. These are light and fulfilling drinks that will help with upset stomach, heartburn and other symptoms of morning sickness.
    • Include some ginger in your diet
      Ginger is an amazing thing for reducing nausea and vomiting. You can consume it grated, with tea, like ginger ale or even as ginger candies.
    • Peppermint and citrus can help
      Peppermint and citrus are two magical foods that are scientifically proven to help soothe heartburn, upset stomach and improve digestion. Besides adding them to your tea or smoothie, try peppermint and citrus candies or even sniff a lemon if you like.

    Besides changing your diet, you also need to change your routine. Keep a track of the following things during your mealtime:

    • Never stay empty stomach as it can increase acidity and develop nausea and heartburn.
    • Avoid sleeping on an empty stomach. This doesn’t mean you munch on heavy foods. Try light snacks and as discussed earlier- easy to digest foods.
    • Always keep a small bag of snacks with you.
    • Let go of foods that trigger nausea.
    • Stick to smaller portions and more 5 to 6 meals a day.

    Do You Need to Consult a Doctor for Your Morning Sickness?

    Generally, morning sickness is a part and parcel of pregnancy. It’s not considered a serious situation that needs medical attention. However, you must contact your healthcare provider if the following situations occur:

    • You are losing weight.
    • You are vomiting blood.
    • You vomit more than 3 times a day.
    • It’s impossible to eat or drink.
    • You are experiencing extreme fatigue.

    References:

    [1] Lee, N. M., & Saha, S. (2011). Nausea and vomiting of pregnancy. Gastroenterology clinics of North America40

    (2), 309–vii. https://doi.org/10.1016/j.gtc.2011.03.009

    [2] Bustos, M., Venkataramanan, R., & Caritis, S. (2017). Nausea and vomiting of pregnancy – What’s new?. Autonomic neuroscience : basic & clinical202, 62–72. https://doi.org/10.1016/j.autneu.2016.05.002

    [3] Gadsby, R., Barnie-Adshead, A. M., & Jagger, C. (1993). A prospective study of nausea and vomiting during pregnancy. The British journal of general practice : the journal of the Royal College of General Practitioners43(371), 245–248.

    [4] Singh, P., Yoon, S. S., & Kuo, B. (2016). Nausea: a review of pathophysiology and therapeutics. Therapeutic advances in gastroenterology9(1), 98–112. https://doi.org/10.1177/1756283X15618131

    [5] Frese, T., Klauss, S., Herrmann, K., & Sandholzer, H. (2011). Nausea and vomiting as the reasons for encounter in general practice. Journal of clinical medicine research3(1), 23–29. https://doi.org/10.4021/jocmr410w

    [6] Mosa, A., Hossain, A. M., Lavoie, B. J., & Yoo, I. (2020). Patient-Related Risk Factors for Chemotherapy-Induced Nausea and Vomiting: A Systematic Review. Frontiers in pharmacology11, 329. https://doi.org/10.3389/fphar.2020.00329

    [7] Chan, R. L., Olshan, A. F., Savitz, D. A., Herring, A. H., Daniels, J. L., Peterson, H. B., & Martin, S. L. (2011). Maternal influences on nausea and vomiting in early pregnancy. Maternal and child health journal15(1), 122–127. https://doi.org/10.1007/s10995-009-0548-0

    [8] Chan, R. L., Olshan, A. F., Savitz, D. A., Herring, A. H., Daniels, J. L., Peterson, H. B., & Martin, S. L. (2010). Severity and duration of nausea and vomiting symptoms in pregnancy and spontaneous abortion. Human reproduction (Oxford, England)25(11), 2907–2912. https://doi.org/10.1093/humrep/deq260

    [9] McCarthy, F. P., Lutomski, J. E., & Greene, R. A. (2014). Hyperemesis gravidarum: current perspectives. International journal of women’s health6, 719–725. https://doi.org/10.2147/IJWH.S37685

    [10] Teasdale, S., & Morton, A. (2018). Changes in biochemical tests in pregnancy and their clinical significance. Obstetric medicine11(4), 160–170. https://doi.org/10.1177/1753495X18766170

    [11] Viljoen, E., Visser, J., Koen, N., & Musekiwa, A. (2014). A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutrition journal13, 20. https://doi.org/10.1186/1475-2891-13-20

    [12] Matthews, A., Dowswell, T., Haas, D. M., Doyle, M., & O’Mathúna, D. P. (2010). Interventions for nausea and vomiting in early pregnancy. The Cochrane database of systematic reviews, (9), CD007575. https://doi.org/10.1002/14651858.CD007575.pub2

    [13] Khorasani, F., Aryan, H., Sobhi, A., Aryan, R., Abavi-Sani, A., & Ghazanfarpour, M. et al. (2019). A systematic review of the efficacy of alternative medicine in the treatment of nausea and vomiting of pregnancy. Journal Of Obstetrics And Gynaecology40(1), 10-19. https://doi.org/10.1080/01443615.2019.1587392

    [14] Einarson, A., Maltepe, C., Boskovic, R., & Koren, G. (2007). Treatment of nausea and vomiting in pregnancy: an updated algorithm. Canadian family physician Medecin de famille canadien53(12), 2109–2111.

    [15] Ebrahimi, N., Maltepe, C., & Einarson, A. (2010). Optimal management of nausea and vomiting of pregnancy. International journal of women’s health2, 241–248. https://doi.org/10.2147/ijwh.s6794

Categories
Complications and symptoms

Molar Pregnancy: A rare complication of pregnancy

Table of Contents

Pregnancy is a life-changing event for every woman. As joyful as the entire journey is, there are various complications and doubts throughout the 9 months. During these months, a woman goes through a lot of physical and emotional turmoil. Any complication during pregnancy is not only dangerous for the child, but also for the mother. One such case is a molar pregnancy. In this article we will cover: can you detect molar pregnancy in ultrasound? What are molar pregnancy symptoms.

Usually, there are two types of complications in pregnancy; non-molar and molar.

  1. Non-molar complications include Placental Site Trophoblastic Tumor (PSTT) and choriocarcinoma.
  2. Molar complications includes complete and partial molar pregnancy.[1]

What is Molar Pregnancy?

Molar Pregnancy, also called Hydatidiform Mole or HM, is a very rare complication of pregnancy. A typical hydatidiform mole is a voluminous mass or swollen, sometimes cystically dilated, chorionic villi, appearing grossly as grapelike structures.

In this complication, which is more properly known as Gestational Trophoblastic Disease (GTD), the trophoblast cells (which normally develop in the placenta) grow abnormally.[1]

Unfortunately, this complication leads to the termination of pregnancy because the fetus is unable to form properly. Instead of a healthily forming fetus, there is a lump of cells that grow in the womb. In a normal pregnancy, the fertilized ovum grows into a fetus with clearly defined cell segregation and maturation. In a molar pregnancy, a tumor-like mass resembling a mole or lump of cells is produced. The accumulation of cells that form a mole-like mass – and the failure to properly develop the placenta – leads to an insufficient supply of oxygenated blood and nourishment.[1]

molar pregnancy

Types of Molar Pregnancy

Complete Molar Pregnancy

In a complete mole, there is no fetal part at all. Instead, there is a mole of abnormal cells that grow abnormally in the uterus.[1]

The levels of the Beta Human Chorionic Gonadotropin hormone is extremely elevated.[1]

Moreover, the two types of trophoblasts in the placenta, called syncytiotrophoblast and cytotrophoblast, are equally proliferated. [1]

A complete molar pregnancy occurs in 2% of all pregnant women. [1]

Partial Molar Pregnancy

As compared to complete moral pregnancy, there is the presence of a fetal part in partial molar pregnancy. However, the fetus is abnormal and is unable to survive, thus leading to termination of pregnancy. [1]

The level of Beta Human Chorionic Gonadotropin is elevated, but not as high as in complete molar pregnancy. [1]

The syncytiotrophoblast and cytotrophoblast cells that are present in the placenta undergo partial and complete proliferation. [1]

There is nearly nil occurrence of partial molar pregnancy among pregnant women. [1]

A complete mole is more dangerous than a partial mole because it has the tendency to convert into choriocarcinoma. [1]

This disease has proven to be quite dangerous . It often leads to cancerous conditions which aggravate with time if adequate treatment is not acquired. [1]

Molar Pregnancy in Ultrasound

In ultrasound, high-frequency sound waves are directed towards the abdominal and pelvic region.

Radiology allows ultrasound tests to detect molar pregnancy as early as nine weeks. When the high-frequency sound waves echo, they produce specific patterns upon imaging.

In case of complete molar pregnancy

Ultrasound scans may reveal an intrauterine mass with cystic spaces associated with the absence of fetal content and amniotic fluid. Moreover, there is a thick cystic placenta that fills the uterus, due to which the uterus appears quite enlarged. Crystal-like structures show the presence of ovarian cysts. [2]

Usually, it is difficult to diagnose molar pregnancy by relying on imaging in the first trimester. This is because the results resemble a normal pregnancy or empty gestational sac. Therefore, less than 50% of cases of molar pregnancy are detected in the first trimester. In ultrasound imaging, theca lutein cysts are quite clearly visible. [2]

The characteristic feature of an ultrasound scan is the snowstorm or bunch of grape appearance. [2]

A color Doppler scan reveals high velocity with a low impedance flow. [2]

In case of partial molar pregnancy

Ultrasound scans can reveal growth-restricted fetuses and low amniotic fluid. There is the presence of fetal and placental content; the fetus is well-developed but the growth is retarded. It presents the fetus dead or alive with hydrophobic degeneration. The placenta is quite thick and large in proportion to the uterine cavity due to cystic-like appearance. The cystic spaces in the placenta are not always present.

Moreover, the ultrasound scan reveals a gestational sac or amniotic cavity which may be empty or may contain amorphous small fetal content. It is surrounded by a thick outline of placental echoes which intermixes with cystic spaces.

A color Doppler scan shows high velocity with low impedance flow. [3]

What are the symptoms of Molar Pregnancy? [4]

In the beginning, everything appears normal. As the pregnancy progresses, symptoms begin to appear in the first trimester. These include: 

  • Vaginal bleeding. This varies in color; from dark brown to bright red, the discharge can appear in any shade.
  • There is often a brownish watery discharge instead of proper vaginal bleeding.
  • In a normal pregnancy, there is nausea and vomiting; in molar pregnancy, the intensity of morning sickness worsens. Thus, the intensity of nausea and vomiting increases and can happen at any time during the day.
  • Sudden severe abdominal pain caused by internal bleeding.
  • Grape-like cysts usually discharge through the vagina.
  • Immense pelvic pain or pressure.
  • The height of fundus is extraordinarily large in the first trimester which indicates abnormality.
  • Sometimes the uterine growth varies between too much and too little.
  • High blood pressure.
  • Proteinuria occurs, which is the presence of protein in the urine after 20 weeks of pregnancy. Proteinuria coupled with high blood pressure is called Pre-eclampsia.
  • Ovarian cysts on the ultrasound.
  • Usually, upon running regular CBC, there is a decrease in red blood cells (RBCs). This condition is called anemia.
  • Thyroid gland overworks, causing intense symptoms of hyperthyroidism.
  • Ultrasound shows no fetal movement or heartbeat; a dead or abnormal fetus.
  • βhCG level,

Most of the symptoms are also observed in normal pregnancy and therefore do not bother the soon-to-be-mother. However, some characteristic symptoms indicate abnormality. Ultrasound tests can confirm the condition of molar pregnancy.

What are the causes of Molar Pregnancy?

The occurrence of molar pregnancy is beyond the control of a woman. It does not happen due to intake or any physical or biological action.

The cause lies solely in genetics.

The two types of molar pregnancy have different patterns of gene involvement. To understand how a flaw in gene mixing causes this, it is necessary to understand the normal process.

In human beings, there are 23 pairs of chromosomes. When a sperm fuses with an ovum, one pair – from both male and female, which are XX and XY respectively – combine.

In a molar pregnancy, the ovum is empty. There are no chromosomes in it. When one sperm fuses with the ovum, it undergoes duplication and the resulting chromosomal number becomes 46 XX or 46YY. The initial chromosomal content after fertilization duplicates, producing abnormal genetic products. In this case, the zygote is homozygous diploid. However, when two sperms fuse an empty ovum, it also undergoes duplication forming 46 XX or 46 XY. [1]

In this case, the zygote is heterozygous diploid. [1]

In a partial molar pregnancy, two normal sperms fuse with one normal ovum. The genetic makeup is 69 XXY, 69 XYY, or 69 XXX. This is due to two sets of chromosomes from the father and one set of chromosomes from mother. [1]

As a result, the zygote is triploid. [1]

What are the risk factors? [5]

Although the occurrence is quite rare, in 1 out of 1000 pregnancies, it is necessary to understand the risk factors. For instance, the most common risk factors are:

Maternal age

In pregnancy, the age of the mother is the most critical and important aspect. The risk of developing a molar pregnancy is higher for women who are older than 45. The risk is equally high when the mother is younger than 20. Therefore, it is necessary to keep age in mind when planning a pregnancy.

Thus, pregnancy in teenage and middle age is the most restricted age for pregnancy.

Previous history

All those women who have had a molar pregnancy before are likely to develop it again. Repetition occurs in 1 out of every 100 women. If a woman has had more than one molar pregnancy, then her chances to develop another are around 1 in 5.

Blood group

Women with blood groups A and AB are at a slightly higher risk of developing molar pregnancy.

Ethnicity

Among all ethnicities, Asian women are most at risk of developing molar pregnancy. As compared to women of other ethnicities, the risk is twice.

Infertility issues

There are numerous women who have difficulty conceiving. This is due to underlying issues concerned with fertility which have a huge impact on the conception. In conclusion, such women often end up with a molar pregnancy.

How to prevent Molar Pregnancy? [6]

A molar pregnancy can only be prevented if you are familiar with the age group which is at highest risk. It is best not to plan pregnancy in teenagers and during middle age, thus avoiding the chance to develop one.

Moreover, if you have had a molar pregnancy before, it is best to wait for 6 to 12 months before another pregnancy. The risk of developing another is 1 in 80 women.

Other than these two preventions, there is nothing else that can be done. Developing a molar pregnancy is not under a woman’s control.

Due to the interference of non-modifiable and uncontrollable factors, a molar pregnancy can’t be prevented.

How is it treated? [7]

It is necessary to understand that such a pregnancy cannot continue since the problem lies at the genetic level. There are some treatment options that must be employed to prevent any fatal complications.

Dilation and Curettage (D&C)

In this technique, shortened as D&C, the abnormal molar tissue is removed from the uterus.

This treatment plan is conducted under the effect of anesthesia. A doctor inserts a speculum into the vagina of a woman to observe the cervix. Next, the doctor dilates the cervix. With the help of a vacuum, the device removes the molar tissue from the uterus.

HCG monitoring

The removal of molar tissue from the uterus does not allow the woman’s body to plan pregnancy again. There is a slight possibility that a small part of molar tissue is still present in the uterus; that tissue basically produces the HCG hormone. A doctor measures the HCG level until it drops to normal. If the level of HCG fails to become normal, then there is a need for additional treatment.

For 6 to 12 months, the HCG levels are continuously under observation.

Hysterectomy

A molar pregnancy can convert into Gestational Trophoblastic Neoplasia (GTN). In case of GTN or no desire for future pregnancies, it is better to remove the uterus.

References

  1.   Kumar, V., Abbas, A. K., & Aster, J. C. (2018). Chapter 19: Female Genital System and Breast. In Robbins Basic Pathology (10th ed.). Pennsylvania: Elsevier.
  2.   Radswiki. (n.d.). Complete hydatidiform mole: Radiology Reference Article. Retrieved June 26, 2020, from https://radiopaedia.org/articles/complete-hydatidiform-mole?lang=us
  3.   Radswiki. (n.d.). Complete hydatidiform mole: Radiology Reference Article. Retrieved June 26, 2020, from https://radiopaedia.org/articles/complete-hydatidiform-mole?lang=us
  4.   Molar pregnancy. (2017, December 14). Retrieved June 26, 2020, from https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/symptoms-causes/syc-20375175
  5.   Gestational Trophoblastic Disease – Risk Factors. (2019, August 01). Retrieved June 26, 2020, from https://www.cancer.net/cancer-types/gestational-trophoblastic-disease/risk-factors
  6.   Molar Pregnancy Prevention. (n.d.). Retrieved June 26, 2020, from https://my.clevelandclinic.org/health/diseases/17889-molar-pregnancy/prevention
  7.   Molar pregnancy. (2017, December 14). Retrieved June 26, 2020, from https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/diagnosis-treatment/drc-20375180
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