Pregnancy loss is more common than you may expect. In fact, one in four pregnancies end in miscarriage. Molar pregnancy is only one type of pregnancy loss and while rare, is still devastating for expecting parents. Here’s what you should know about molar pregnancies, including how it’s detected, and when you can try to get pregnant again.
What Is a Molar Pregnancy?
A molar pregnancy, or gestational trophoblastic disease (GTD), happens when a genetic error occurs when the egg and sperm join together during fertilization. This error leads to the growth of abnormal tissue within the uterus, and rarely leads to a developing embryo or viable pregnancy.
The tissue growth during a molar pregnancy, also known as a hydatidiform mole, grows rapidly and forms as a cluster of cells. There are two types of molar pregnancies:
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Complete: A complete molar pregnancy only contains placental parts, and happens when the mother’s chromosomes are missing upon fertilization. The placenta begins to form in the uterus and produces the pregnancy hormone hCG, which results in a positive pregnancy test; however, no fetus truly forms.
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Partial: In a partial molar pregnancy, the mother’s chromosomes are present, but there are two copies of the father’s genes resulting in too many chromosomes. Because of this, the growth of abnormal cells contains an embryo that has severe defects. Unfortunately, this embryo isn’t viable and can’t develop properly, and the developing mass will eventually grow over the embryo.
Who Is at Risk for Molar Pregnancy?
Molar pregnancies are fairly rare. Only about one in 1,000 pregnancies in the United States results in a molar pregnancy. Risk factors include:
- Women under the age of 20 or over the age of 40
- Women who have had a previous molar pregnancy
- Women with a history of miscarriage
How Is a Molar Pregnancy Detected?
While the only definitive way to know that a molar pregnancy has occurred is through an ultrasound, other indicators may include:
- Vaginal spotting or bleeding
- Severe nausea or vomiting
- Early preeclampsia
- Grape-like cysts passing from the vagina
- Abnormally high hCG levels
How Is a Molar Pregnancy Treated?
In many cases, a molar pregnancy will end on its own spontaneously, and the tissue is passed through the uterus. Other times, a provider may prescribe a medication in order to help the body begin the process of expelling the tissue, or recommend a procedure under anesthesia known as a dilation and evacuation (D&E), or dilation and curettage (D&C).
Following a molar pregnancy, your provider will continue to monitor your hCG levels, sometimes over the course of several months. Your provider will also continue to ensure the mole has been removed completely. If small traces are left in the uterus, the cells can begin to grow again, resulting in Persistent Gestational Trophoblastic Neoplasia (GTN). Persistent GTN may need to be treated with chemotherapy.
When Can I Get Pregnant Again after a Molar Pregnancy?
In order to ensure that the molar pregnancy doesn’t begin to grow again, it’s important to wait a year after diagnosis to try to get pregnant again. Your provider will highly recommend using birth control in order to ensure a pregnancy doesn’t occur. Many methods of birth control are safe following a molar pregnancy, with the exception of an intrauterine device. The good news is that when your provider has cleared you to try and get pregnant again, the risk of another molar pregnancy occurring is still very rare.
If you experienced a molar pregnancy, remember that even though there wasn’t a viable embryo, feeling a sense of loss or a mix of emotions is completely normal and expected. Take time to process and heal, while continuing to focus on your after-care. You might find it helpful or comforting to talk to other women who have experienced early pregnancy loss.