Women with molar pregnancies feel pregnant, and usually the symptoms themselves cannot be directly pointed to molar pregnancy. Only a doctor can with certainty detect molar pregnancy with sonogram. The symptoms of molar pregnancy are the following:
- Vaginal spotting or bleeding
- Nausea and vomiting
- Thyroid disease or very early preeclampsia (toxemia).
Preeclampsia that occurs earlier than 20 weeks of pregnancy is worrisome and doctor will definitely have to use sonogram to detect abnormalities. Pelvic exam might detect smaller or larger uterus than expected. It is also possible that the exam might reveal enlarged ovaries, or possibly non-cancerous ovarian cysts, and abnormally high levels of HCG. It is also very possible that the ultrasound might detect abnormal placenta that will show cluster of grapes appearance or a snowstorm appearance, all signs of abnormal placenta.
There is an additional sign of molar pregnancy, which might not be that obvious and that is that almost most cases of molar pregnancy occur after a miscarriage, or after ectopic pregnancies or after a normal pregnancy. Unfortunately, there are no other treatment options but to remove molar pregnancy. Treatment consists of dilation and curettage of the uterus: patient is under anesthesia, a small vacuum device is inserted into uterus, and the molar pregnancy is removed. This procedure has to be done very carefully in order to prevent excessive bleedings. As with any other removal, tissue removed is sent to pathologist to make the final diagnosis. There are cases when hysterectomy is a preferable option that is in cases when woman is over 50 years and has completed her childbearing.
After the removal of molar pregnancy, it is very important for woman to have regular checkups with her doctor, and in most cases it is highly recommendable not to get pregnant for at least 1 year. Regular checkups might involve: a baseline chest x-ray, review of the pathology specimen, physical examination of the vagina and uterus every 2 weeks until the uterus returns to normal then every 3 months for a year. Regular checkups are very important because there is a possibility that molar pregnancy recurs, and if they come back woman might need chemotherapy to prevent the microscopic placental cells from spreading to other organs like cancer.
This is fortunately very unlikely to occur with partial molar pregnancies, while in complete molar pregnancies there is 20% chance this might happen. Although for most it is frustrating that they have to wait 1 year to try to get pregnant again after molar pregnancy. The risk of having another molar pregnancy is about 1%, but the waiting period is very important and woman experiencing molar pregnancy should respect the doctor's advice.