Molar pregnancy

Types of trophoblastic disease

Hydatidiform mole where the abnormal placental tissue growth is benign but capable of spreading if not treated.

There are two types:

• partial mole where only part of a normal placenta shows overgrowth - any baby that is present is not developing normally
• complete mole where the entire placenta, which is growing rapidly, is abnormal, and there is no baby present

Persistent trophoblastic disease where part of a previous mole remains after treatment. Even a tiny piece of mole in any part of the body can grow rapidly and cause problems.

Choriocarcinoma is a very rare cancer, which is curable. In this case, the placenta develops a malignancy, which can spread throughout the body. It can occur in a molar pregnancy, a miscarriage, an ectopic pregnancy, and even following an otherwise normal pregnancy.

Signs of a molar pregnancy

• vaginal bleeding
• the womb grows more quickly than normal
• no foetal movements
• leaking from the vagina of material that looks like a cluster of grapes
• excessive vomiting in early pregnancy due to a higher level of the pregnancy hormone hCG (human Chorionic Gonadotrophin) than normal

Diagnosing a molar pregnancy

1. Ultrasound scanning enables early diagnosis of molar pregnancy - especially in the case of a complete mole. Incomplete moles can be more difficult to identify if some parts of the foetus are present - if there is any uncertainty a repeat scan will be arranged.

In a Twin pregnancy where one is a partial molar pregnancy, the pregnancy is usually allowed to go ahead. It can also proceed if there's a complete mole alongside a normal pregnancy, but couples will be counselled about the risks involved:

• reduced live birth rate of 25 per cent
• risk of haemorrhage or pre-eclampsia
• subsequent need for chemotherapy in about 20 per cent of cases

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