Q. What is a molar pregnancy?

A. Molar pregnancy, also called hydatidiform mole, is a rare type of complication seen in pregnancy. It is characterized by an abnormal growth of the trophoblasts, which are the cells that later develop into the placenta (an organ that develops during pregnancy and provides oxygen and nutrients to the growing baby, while removing the waste products from the baby’s blood).

Q. Is molar pregnancy common ?

A. Yes, globally approximately one in every one thousand pregnancies is a molar pregnancy. In India, one in every 160 pregnancies is a molar pregnancy.

Q. Who treats molar pregnancy?

A. Molar pregnancy is treated by a gynecologist.

Q. When is molar pregnancy commonly seen?

A. A molar pregnancy may be commonly seen in the following cases: Age of the mother is less than 20 years or more than 40 years Family history Asian race History of a molar pregnancy Nutrient-deficit diet Infection of the blood or uterus Preeclampsia (very high blood pressure)

Q. Can molar pregnancy occur more than once?

A. Yes, about one in 100 women could have a repeat case of molar pregnancy if they have had a molar pregnancy before.

Q. How does molar pregnancy occur?

A. A molar pregnancy can occur due to the following reasons: The fertilization of an empty female egg Double fertilization of the female egg (fertilization of a female egg by two male sperms instead of one, causing 69 chromosomes in the embryo instead of the usual 46) Genetic tendency of the male sperm to grow abnormally quickly, causing a benign tumor formation instead of a viable pregnancy

Q. Can a woman die due to molar pregnancy?

A. Yes, if the molar pregnancy is not eliminated in a timely manner, a woman may bleed to death or could develop a rare type of cancer known as gestational trophoblastic neoplasia (GTN).

Q. Can I have a healthy pregnancy after being treated for a molar pregnancy?

A. The chances of a healthy conception despite an earlier molar pregnancy is approximately 50%.

Q. What is the cost of molar pregnancy treatment in India?

A. The cost of molar pregnancy treatment varies depending on the type of treatment performed and the condition of the patient. The cost also varies among different gynecologists in different hospitals. On average, the cost of molar pregnancy treatment using medications is between INR 2,000 to INR 3,000. The cost of molar pregnancy treatment using surgical methods is between INR 20,000 to INR 40,000. Cost of Molar Pregnancy Termination treatment in India CITY COST Mumbai INR 30000- INR 40000 Bangalore INR 30000- INR 35000 Delhi INR 30000- INR 35000 Chennai INR 30000- INR 35000

Q. Can I have sex after molar pregnancy treatment?

A. You should wait for at least two weeks after molar pregnancy treatment to resume any sexual activity. Make sure to use contraceptives while having sex, as a pregnancy within six to twelve months of having a molar pregnancy treatment may have a high risk of turning non-viable, that is, a pregnancy that cannot sustain and needs to be eliminated.

Q. Can the unborn baby be saved in molar pregnancy?

A. No, an unborn baby cannot be saved in a molar pregnancy as the embryo will never grow into a normal fetus or placenta, and the pregnancy is non-viable.

Molar Pregnancy Termination

A molar pregnancy cannot sustain itself and should be removed at the earliest. This is so as the embryo does not develop into a child in this type of pregnancy. In fact, the fetus and placenta quickly grow in the form of a benign or non-cancerous tumor. If the condition is left untreated, it may lead to severe risks to the health of the mother and may even turn into a rare type of cancer, and may cause severe bleeding that may cause death.

Types:
There are two types of molar pregnancies, which are:

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The following symptoms may be noticed in a woman having a molar pregnancy:

Severe nausea
Vomiting
Bright red to dark brown bleeding from the vagina during the first trimester
Pelvic pain
Pelvic pressure
Vaginal passage of grape-like cysts
High blood pressure
Rapid growth of the uterus
Anemia
Hyperthyroidism (overactive thyroid gland)
Presence of ovarian cysts
Preeclampsia (a condition that leads to high blood pressure and protein in the urine after about 20 weeks of pregnancy)

Physical examination: The doctor will evaluate the physical health of the pregnant woman. The medical history, family history, and symptoms of the woman are noted.
Blood tests: These tests are performed to measure the human chorionic gonadotropin (HCG) levels in the blood. Conditions like hyperthyroidism and anemia can also be diagnosed through blood tests.
Transvaginal ultrasound: A transvaginal ultrasound is done by inserting the sound wave device through the transvaginal cavity. An ultrasound for a complete molar pregnancy, which could be detected as early as eight or nine weeks of pregnancy, could show no fetus or embryo, no amniotic fluid, ovarian cysts, and a thick cystic placenta that nearly fills the uterus. An ultrasound for a partial molar pregnancy may show a fetus that is too small for its gestational age, low amniotic fluid, and a placenta that appears abnormal.
CT scans and MRI scans: These are imaging tests that can help in confirming the diagnosis of a molar pregnancy.

A molar pregnancy cannot be continued as a viable pregnancy. The abnormal placenta tissue must be removed to prevent complications. This may be done in the following ways:
Medical termination:
It is not preferred to terminate a molar pregnancy through medicines due to the longer time taken, a need for continuous monitoring, and the requirement for regular follow-ups.
However, if a molar pregnancy has been detected early and the patient favors medicinal treatment, medical termination may be performed.
A medicine known as methotrexate is given in the form of an injection as a single dose.
The HCG levels are monitored before and after the procedure. If the levels fail to decrease after the first dose, a second dose may be required.
An ultrasound is performed to confirm the termination of the pregnancy.

Surgical treatments:
A: Dilation and curettage (D & C):

The procedure is done under local anesthesia (the area of treatment is numbed) or general anesthesia (the patient is put to sleep during the procedure).
You will be positioned on your back with your legs in the stirrups.
The doctor will insert a speculum into the vagina to see your cervix (lower end of the uterus).
The cervix will then be dilated and the uterine tissue is removed using a vacuum device.

B. Hysterectomy:

If there is an increased risk of gestational trophoblastic neoplasia (GTN) (tumor formation) and the patient does not desire any future pregnancies, the uterus may be removed.
This procedure is known as hysterectomy.
This procedure is generally performed under general anesthesia.
Following the removal of the molar tissue, the HCG levels will be continuously monitored for up to six to twelve months till they return to their normal levels. If HCG is detected in the blood, the patient may require additional treatment.

The complications following a molar pregnancy termination may include the following:

Bleeding
Infection
Blood clot formation
Allergic reaction to the anesthesia used
Persistent gestational trophoblastic neoplasia (GTN), which can be treated using chemotherapy drugs (drugs used for cancer treatment) or hysterectomy
Choriocarcinoma (a cancerous form of GTN that spreads to the other organs)
Death due to excessive bleeding (rare)

You may feel slightly numb and confused once you wake up from the effect of the anesthesia.
You may have some discomfort or pain near the surgical area. Painkillers may be recommended to ease your discomfort.
If your hemoglobin levels are less than normal, a blood transfusion may be needed.
In most cases, you will be discharged on the same day or the next day after surgery.
It is normal to have some vaginal bleeding for up to six weeks after surgery.
It may take several weeks before you recover completely and your menstrual cycle returns back to normal.
You can resume having sex about two weeks after the surgery, however, you should use contraceptive methods while having sex.
You should wait for at least six to twelve months before planning another pregnancy.

Cost of Molar Pregnancy Treatment in India-

The cost of molar pregnancy termination using medications is approximately INR 2,000 to INR 3,000.
The cost of a surgical procedure performed to treat molar pregnancy in Mumbai is between INR 25,000 to INR 40,000.
The cost of a surgical procedure performed to treat molar pregnancy in Delhi is between INR 22,000 to INR 38,000.
The cost of a surgical procedure performed to treat molar pregnancy in Bangalore is between INR 22,000 to INR 38,000.
The cost of a surgical procedure performed to treat molar pregnancy in Chennai is between INR 20,000 to INR 35,000.