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Molar pregnancy or hydatidiform mole: definition
It is a very rare complication of pregnancy. For some reason, the placenta sometimes grows abnormally. This results in the formation of a small tumor, called a mole. The mole can be “complete”, then there will never be an embryo or fetus. In the case of a partial mole, an embryo can develop but will not be viable. In all cases, this type of pregnancy cannot continue. The woman then most often miscarries. In France, the frequency of moles is around 1 per 1000 pregnancies.
Symptoms of a molar pregnancy
The first symptoms usually appear in the first trimester and are similar to those of a classic pregnancy. They usually appear in the first trimester. The woman then feels nausea, vomiting. Also, her stomach is abnormally swollen and she is losing blood. Gradually, the bleeding and the pain intensify. It is then necessary urgently consult his gynecologist who will perform an ultrasound to diagnose the mole.
The management of a molar pregnancy: the level of HCG
A mole does not drain naturally. The gynecologist usually performs an aspiration to evacuate it. But, there may be some molten tissue left in the uterus. The risk is that this tissue will proliferate again. The woman should therefore take a blood test every week to check that her HCG hormone levels (pregnancy hormone) is zero. In 90% of women, this test becomes negative quickly and permanently. In the event of a partial mole, the blood tests may be stopped, if the rate is negative for at least three consecutive weeks. Women who have had a complete mole, on the other hand, will have to continue blood tests on a monthly basis for 6 months after the negativity of the established test.
Possible complications
What happens if the mole does not disappear completely or reappears later? The doctor can perform a curettage again. If despite this operation, the level of the hormone HCG does not quickly become negative, we speak of invasive mole or choriocarcinome. Women with this complication most often have to undergo chemotherapy. Fortunately, the cure rate for this type of cancer is close to 100%. And normally, there is no effect on fertility.
Can we try a new pregnancy after a molar pregnancy?
After the mole has been evacuated, the women have bleeding for a few days. It is advisable not to use a tampon during this period. In principle, the rules reappear in the following month and a half. But you must remain vigilant and consult your doctor if bleeding occurs outside of the rules. It is quite possible to take the pill after evacuation of the mole. An IUD can also be inserted within 6 weeks after curettage. At last, as soon as the follow-up is finished, you can consider a new pregnancy with confidence. The risk of mole for this new pregnancy is very low, around 0,5 to 1%.