Molar pregnancy

2. Laboratory examination and testing after a miscarriage, termination or an ectopic pregnancy, the placenta is always examined by a pathologist.

In molar pregnancies the abnormal overgrowth of the placenta leads to excessive production of the pregnancy hormone human Chorionic Gonadotrophin (hCG).

A simple blood or urine sample can determine levels of hCG, and:

• help to diagnose a molar pregnancy
• indicate when the disease is cured - as it improves, levels fall, and when there's no disease in the body, the level of hCG in the blood or urine is virtually zero

Treating a molar pregnancy

Dilatation and Curettage (D&C or 'scrape') is carried out to remove as much of the placenta from the womb as possible.

It may be necessary to repeat this procedure because even a tiny amount of mole left in the body can grow and spread. In the majority of cases this operation does cure the disease. Chemotherapy is necessary in about 6-10 per cent of cases with the following symptoms:

• hCG levels have risen for two weeks or more
• examination of tissue has shown choriocarcinoma
• the disease has spread to other areas
• hCG levels have increased after a normal value

What are the chances of having another baby?

This is a highly curable disease and the prognosis is good even when it has spread to other organs.

If the disease is limited to the womb cavity, it is 100 per cent curable, and less than 1 in every 10 women will require chemotherapy.

But if a woman gets pregnant too soon after the molar pregnancy, the risk of a recurrence is increased and the mole can reactivate. Because the disease is assessed by measuring the levels of hCG hormone - usually only seen in pregnancy - it is important to avoid getting pregnant during the follow-up period.

For the same reason, any hormone treatments, including the Pill, should not be used for at least three months after the 'all-clear' is given.

Your doctor will continue to monitor your condition for between six months and two years, depending on the type of mole.

You may feel fine during this time but it is really important to continue with the monitoring process - any high or rising levels of hCG in your blood will warrant further investigation and treatment.

Most importantly, after the disease has been cured, you should be able to have a normal, healthy pregnancy and remain free from the disease for the rest of your life.

We are fortunate in the UK to have an effective registration and treatment programme for molar pregnancies.

Charing Cross Hospital in London, Ninewells Hospital in Dundee and Weston Park Hospital in Sheffield are the three centres established in the UK to screen for gestational trophoblastic tumours, and they provide information and support for patients undergoing treatment.

Here are two useful websites which have further information:

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