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1. Molar Pregnancy Mr Yogendra Mehta Lecturer, HOD(Adult Health Nursing TU IOM BNC

2. Introduction A molar pregnancy occurs when an egg and sperm join incorrectly at fertilization and create a noncancerous tumor.  A molar pregnancy will not be able to survive. It happens by chance and is rare . A placenta doesn’t form normally in molar pregnancies . Most people receive treatment and go on to have healthy future pregnancies . The tumor looks like tiny water-filled sacs, similar to a cluster of grapes . The tumor can’t support a developing embryo and the pregnancy ends. Some people have a miscarriage . Surgery is needed to remove the pregnancy.

3. Introduction Some people have a miscarriage . Surgery is needed to remove the pregnancy . If left untreated, molar pregnancies can cause serious complications . Molar pregnancies are a type of gestational trophoblastic disease.  Gestational trophoblastic disease (GTD) is a group of conditions that cause tumors to grow in uterus. Molar pregnancies are also called hydatidiform moles.

4. Types Complete molar pregnancy No embryo forms. It happens when a sperm fertilizes an empty egg . Egg contains no chromosomes. Embryo gets 23 chromosomes from the sperm.   Placental tissue grows but is abnormal and contains fluid-filled cysts (or tumors).  This tissue produces the pregnancy hormone HCG which is made by a healthy placenta during pregnancy. This can make feel like pregnant and give a positive pregnancy test.

5. Contd ….. Partial molar pregnancy Occurs when an abnormal placenta forms along with an embryo, and two sperm fertilize one egg . Embryo having 69 chromosomes. In these cases, the growing embryo has an extra set of chromosomes. The embryo may start to develop but generally can’t survive.

6. Risk Factors Y ounger than age 20. Are over 40 yrs. Have a history of molar pregnancies. Have had two or more miscarriages . Less than 1% of all pregnancies — about 1 in 1,000 — are molar pregnancies .

7. Causes Caused by genetic errors that occur during the fertilization of an egg by a sperm.

8. Clinical Features Vaginal bleeding within the first three months of pregnancy. Severe nausea and vomiting. Grape-like cysts coming out of your vagina. Preeclampsia (extremely high blood pressure). Abnormally high HCG levels. Abdominal swelling. Anemia

9. Diagnostic Approach Routine prenatal tests (usually in the first trimester ). Ultrasound   of uterus often shows several fluid-filled sacs instead of a placenta.  Measure HCG levels in your blood: abnormally high level

10. Management Molar pregnancy must be removed from body. it can cause serious complications . First line treatment: Dilation and Curettage (D&C) with suction to remove all abnormal tissue from your uterus.  Surgical approach: remove molar pregnancy,  H ysterectomy Oxytocin: help uterus to contract and expel the contents.   HCG Monitoring until levels return to normal.

11. Complications Abnormal cells may grow into the muscle layer around your uterus (also called an invasive mole ). Choriocarcinoma   Infection of the blood (sepsis ) Uterine infection. Preeclampsia (very high blood pressure). Shock (very low blood pressure).

12. Prognosis Most people who receive treatment for a molar pregnancy have no further complications.  Slightly higher risk of a second molar pregnancy .   It doesn’t cause infertility . A void becoming pregnant for up to three months. This allows your HCG levels to return to prepregnancy levels.