Hydatidiform Mole (excerpted)
Source: The Women's the royal women's hospital 2007
The following information is for patients who have been diagnosed as having a hydatidiform mole. Hydatidiform mole occurs in approximately 1 in 1500 pregnancies. This uncommon condition may be difficult to understand; especially at a time of disappointment for you and your partner, after the loss of your pregnancy.
What occurs in a normal pregnancy?
The woman's ovum (eff) is fertilised in the fallopian tube and two or three days later the fertilized egg moves into the uterus (womb) where it attaches to the inner wall. The outer part of the fertilised egg forms the placenta (after birth) and the inner part develops into a fetus (baby). The placenta produces a pregnancy hormone called Human Chorionic Gonadotrophin (hCG). This hormone is what gives you pregnancy symptoms such as morning sickness, tender breasts, and lack of energy.
What occurs in a hydatidiform mole pregnancy?
In a hydatidiform mole pregnancy, the baby does not develop and only the placenta forms. This placenta is abnormal, larger and contains many cysts (sacs of fluid).
Why is it called a hydatidiform mole?
The first part of the name comes from the Greek work 'hydatis', meaning droplet. These droplet like structures appear to burrow into the wall of the uterus, hence the name mole.
Why did I develop a hydatidiform mole?
Hydatidiform mole occurs because of a breakdown in the normal joining of chromosomes at fertilization. Neither you or your partner contributed to this abnormal pregnancy.
Why do I need to be monitored?
Although it may seem like the hydatidiform mole has been completely removed, in about ten percent of cases some cells may remain. These cells continue to produce the pregnancy hormone hCG. We monitor you by testing for this hormone in your urine or blood. If the hormone level does not decrease, then it is likely that some abnormal cells remain.
How often will I have to give urine or blood samples and for how long?
Samples are analysed each week until the hormone level becomes normal. If a normal level is achieved within two months, then there is no need for any further follow up. If a normal level is not achieved within two months, we will continue to monitor you with weekly urine or blood samples until the level becomes normal and then monthly samples for the next 12 months.
If the hormone level rises, what treatment will I need?
If the hormone level does not decrease you will be asked to attend the hospital for some tests. these will include blood tests, a chest x-ray, and an ultrasound.
What is a partial mole and will I still need treatment?
A partial mole means that the changes in the placenta are less obvious. Usually a baby does develop, but dies in the womb. The likelihood of needing drug treatment after a partial mole is extremely rare. Patients registered with a partial mole will be monitored by weekly urine or blood samples until the hCG hormone level becomes normal. Once this occurs monitoring will stop.
When can I get pregnant again?
After a partial mole: Before trying to get pregnant again, your doctor will need to confirm you had a partial mole and that you have a normal hormone level in your urine or blood. You will also need one final check up and to have had one normal period.
After a complete mole: If a normal hormone level is achieved within two months, then testing can stop and you can try to get pregnant. If you have been monitored for more than two months, we recommend that you should not try to get pregnant until 12 months have passed, following a normal hormone level. This is because if you get pregnant before then, we will not know if the hormone increase is due to a normal pregnancy, or due to cells from the hydatidiform mole.
What contraception should I use?
You can use any contraception you and your partner are happy with.
What are the chances of a hydatidiform mole in the future?
The chance of a hydatidiform mole occurring again is about one percent. When you think you are pregnant, let your doctor know so that an early ultrasound examination can be arranged. Six weeks after the delivery of your baby, we would like you give the registry one further urine/blood sample for hormone analysis.
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