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Molar Pregnancy


Disease: Molar Pregnancy Molar Pregnancy
Category: Gynecological diseases
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Disease Definition:

A noncancerous (benign) tumor that develops in the uterus is called a molar pregnancy or a hydatidiform mole. When the placenta develops into an abnormal mass of cysts rather than becoming a viable pregnancy, this condition occurs.

One of the types of gestational trophoblastic disease (GTD) is molar pregnancy. There's no embryo or normal placental tissue in a complete molar pregnancy, while there is an abnormal embryo and possibly some normal placental tissue in a partial molar pregnancy. In the case of a partial molar pregnancy the embryo is malformed and can’t survive despite the fact that it begins to develop.

Including a rare form of cancer, a molar pregnancy can have serious complications and requires early treatment. The chance for future healthy pregnancies might be preserved by careful monitoring after a molar pregnancy.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


At first, a molar pregnancy may seem like a normal pregnancy; however, most molar pregnancies cause specific signs and symptoms that include:



  • Rarely, pelvic pressure or pain
  • Severe nausea and vomiting
  • Dark brown to bright red vaginal bleeding during the first trimester
  • Vaginal passage of grape-like cysts

A woman should consult her health care provider when experiencing any signs or symptoms of a molar pregnancy. Other signs of a molar pregnancy like the following might be detected:



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


An abnormally fertilized egg is the cause of a molar pregnancy. 23 pairs of chromosomes are normally contained in human cells; one chromosome in each pair comes from the mother, the other from the father. All of the fertilized egg's chromosomes come from the father in a complete molar pregnancy. The father's chromosomes are duplicated and the chromosomes from the mother's egg are lost or inactivated shortly after fertilization. The egg may have had no nucleus or an inactive nucleus.

The mother's chromosomes remain but the father provides two sets of chromosomes in a partial or incomplete molar pregnancy. Consequently, instead of 46 chromosomes, the embryo has 69 chromosomes. If two sperm fertilized a single egg or when the father's chromosomes are duplicated, this can happen.

Up to an estimated 1 in every 1,000 pregnancies is molar. Some of the factors that may increase the risk of molar pregnancy include:

The risk of molar pregnancy is higher for women of Southeast Asian descent.

Previous molar pregnancy:
A woman is more likely to have another molar pregnancy if she has had one before. 1 in 100 is the risk of a repeat molar pregnancy.

Maternal age:
For a woman younger than the age of 20 or older than the age of 35, a molar pregnancy is more likely to happen.



Molar tissue may remain and continue to grow after a molar pregnancy has been removed. Persistent gestational trophoblastic disease (GTD) is the name of this condition. It occurs in about 10% of women after a molar pregnancy — usually after a complete mole rather than a partial mole. An HCG level that remains high after the molar pregnancy has been removed is one sign of persistent GTD. Causing vaginal bleeding, an invasive mole penetrates deep into the middle layer of the uterine wall in some cases. Most often with chemotherapy, persistent GTD can nearly always be successfully treated. The removal of the uterus (hysterectomy) is another treatment option.

A cancerous form of GTD known as choriocarcinoma develops and spreads to other organs in some rare cases. With multiple cancer drugs, choriocarcinoma is usually treated successfully.


The molar tissue must be removed to prevent complications, as a molar pregnancy can't continue as a normal viable pregnancy.

With a procedure called dilation and curettage (D and C), the health care provider will remove the molar tissue from the uterus of the patient to treat a molar pregnancy. A D and C is usually done as an outpatient procedure in a hospital.

The patient will receive general or local anesthesia and lie on her back with her legs in stirrups during the procedure. A speculum will be inserted into the patient's vagina, as in a pelvic exam, to see her cervix. Then, the cervix will be dilated and with a vacuum device, the uterine tissue will be removed. A D and C usually takes between 15 minutes to half an hour.  

The uterus may be removed (hysterectomy) if the molar tissue is extensive and there's no desire for future pregnancies.

The health care provider will again measure the patient's HCG level after the molar tissue is removed. The patient may need additional treatment if she continues to have HCG in her blood. To make sure there's no remaining molar tissue, the health care provider will continue to monitor the HCG levels of the patient for six months to one year once treatment for the molar pregnancy is complete. Before trying to become pregnant again, the health care provider may recommend waiting up to one year because it is difficult to monitor HCG levels during pregnancy.


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