2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21
Molar pregnancy is a type of pathology in which the fetus stops developing for some reason or is absent altogether. Doctors call a fertilized egg, which cannot become a full-fledged embryo, a "mole", from which the name of the violation comes. Such an anomaly of pregnancy occurs in one woman out of one and a half thousand. The main provoking factors include the age of the mother under twenty years of age or over thirty-five, as well as a history of chorionadenomas.
Mechanisms for the development of pathology
Doctors distinguish two types of molar pregnancy, which differ in the mechanisms of development. The embryo may not develop, but placental tissue does form. As a rule, this happens if the woman’s eggs lack the maternal chromosome (the chromosome is either lost orunsuitable). The germ cell is fertilized by one or two spermatozoa. That is, a fertilized egg contains only the father's chromosomes. The fetus does not develop, and the placenta degenerates into a cyst. In this case, ultrasound diagnostics will show that there is no embryo, but only placental tissue. This is a complete molar pregnancy.
With a partial mole, the mother's chromosome set is normal - 23 pairs of chromosomes. But on the father's side, a double number of chromosomes is observed, that is, 46. This happens if the egg is simultaneously fertilized by two spermatozoa and pathology develops, or if there is a duplication of the chromosome set in one spermatozoon. In this case, the placenta is formed from pathological and normal tissue. The embryo begins to develop, but freezes because it is not viable. With partial pathology, the doctor can detect the embryo, amniotic fluid and fetal membranes on ultrasound.
Causes of molar pregnancy
The main cause of pathology are problems in the transfer of genetic information during conception. This is a rather rare occurrence. The following factors increase the likelihood of an anomaly:
- women's age is under twenty and over thirty-five;
- presence of a history of certain diseases (in particular, chorioadenomas).
Risk factors have not yet been identified. There is a version that a molar pregnancy can be caused by a deficiency of carotene (pigment,contained in red and orange vegetables and fruits), which in the human body turns into vitamin A. Women in Southeast Asia (especially Vietnamese and Korean women) have a slightly increased risk of pathology. There are some dietary theories as to why Asian women are at increased risk.
After a molar pregnancy, which has an average 1-2% chance of occurring, the chances of another normal pregnancy are high. With two previous pregnancies with impaired transmission of genetic information, the probability of conceiving and bearing a he althy child is reduced by 15-20%.
Main symptoms of pathology
In the early stages, molar pregnancy is no different from physiologically normal. Minor spotting, nausea and bouts of vomiting, spasmodic pain in the lower abdomen, an increase in the volume of the abdomen may appear. With pathology, the uterus usually enlarges faster than it does in women with normal pregnancies. Bloody discharge can turn into heavy bleeding. All these alarming symptoms usually appear at 8-9 weeks of pregnancy, but can also occur between the 6th and 12th.
In the presence of spotting in early pregnancy and pain in the abdomen, you should immediately consult a gynecologist. The doctor will order a blood test to determine the level of hCG, and will also refer the patient for an ultrasound.
In molar pregnancy, hCG is significantly higher than expectedterm. The active release of the hormone is caused by the rapidly forming tissue of the placenta. With a partial mole, the hCG level may be normal or slightly increased, which complicates the diagnosis. In this case, specialists usually suspect oncology. Ultrasound shows multiple cysts or no embryo at all.
Treatment of abnormal pregnancy
The only outcome of the pathology is the removal of a non-developing embryo from the uterus. If the diagnosis is confirmed at home, the woman cannot be helped by anything, treatment is carried out only in the hospital. If there are no complications and a pathological pregnancy was diagnosed in time (8-9 weeks - no more), then on the same day the woman can go home. Embryo removal is performed by curettage or vacuum extraction. During the procedures, pathological material is removed from the uterine cavity.
Carrying out scraping
Curtage of the uterine cavity today is carried out in two ways: it is either hysteroscopy or separate cleaning. The first option is safer for a woman and more convenient. The process uses a large device that is inserted into the internal organ and allows you to see the course of the entire treatment process. Traditionally, curettage is performed “blindly”, which increases the risk of complications and disorders associated with damage to the internal genital organs.
Carrying out the procedure does not guarantee that there will be no pathological material left in the internal organs of the woman's reproductive system. In 11% of patients, complications associated with incompleteremoval of a frozen embryo or an empty fetal egg. With a complete molar pregnancy, this figure ranges from 18 to 29%. This deviation is called persistent trophoblastic neoplasia. Pathology is treated by chemotherapy. In rare cases, it can degenerate into a malignant neoplasm - this is the most dangerous consequence of a molar pregnancy.
Vacuum extraction for pathology
During vacuum extraction, the device is inserted through the vagina into the uterine cavity, negative pressure is created and the fetus or other pathological inclusions are removed. The procedure is carried out only on terms (up to six weeks). For up to twelve weeks, the method can be used with the necessary equipment and after special training. After the procedure, the material extracted from the uterus must be sent for examination in order to confirm the anomaly (histological and genetic examination).
Planning for the next pregnancy
Planning the next pregnancy after an abnormal one is possible only after a year. This will allow the hCG levels to drop to a normal level, which will reduce the risk of developing pathology. If a woman becomes pregnant earlier, then it will be more difficult for the gynecologist to observe the patient in terms of hCG levels. It will not be known for sure whether the pregnancy is proceeding normally. To avoid negative consequences, it is better to use protection and wait for the best time to conceive.
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