Hydatidiform mole is a type of gestational trophoblastic disease caused by the abnormal multiplication of cells in the placenta, resulting in symptoms such as prune juice-like vaginal bleeding in the first trimester, or severe nausea and vomiting.
The cause of hydatidiform mole, also called molar pregnancy, is caused by genetic changes, which can be partial or complete, and are differentiated by the presence or absence of the embryo.
Hydatidiform mole treatment is carried out by an obstetrician and generally involves uterine dilation and curettage, surgery to remove the uterus and monitoring beta-HCG levels.
Symptoms of hydatidiform mole
The main symptoms of hydatidiform mole are:
- Vaginal bleeding in the first trimester of pregnancy;
- Bleeding that looks like prune juice;
- Intense nausea and vomiting;
- Tissue coming out of the vagina with the appearance of water drops or grape-like clusters.
Additionally, due to high levels of beta-HCG, after the first trimester, around weeks 14 to 16, a woman may also experience symptoms of hyperthyroidism, such as hand tremors and heart palpitations. Know how to identify the symptoms of hyperthyroidism.
Hydatidiform mole must be diagnosed as soon as possible to avoid complications that may arise if the pregnancy advances into the second trimester, such as pre-eclampsia, pulmonary embolism or acute pulmonary edema, which can put the woman’s life at risk.
If you have symptoms of hydatidiform mole, make an appointment with an obstetrician in the nearest region:
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Is hydatidiform mole cancer?
Hydatidiform mole is a benign tumor of the placenta, but it can evolve into a malignant tumor, that is, cancer, since trophoblastic proliferation can continue even after treatment.
Therefore, it is important to carry out treatment as quickly as possible and undergo regular medical monitoring, with tests to measure beta-HCG levels.
How to confirm the diagnosis
The diagnosis of hydatidiform mole is usually made by the obstetrician during a prenatal obstetric ultrasound in the first trimester of pregnancy, which is also performed when a woman presents with vaginal bleeding in the first trimester.
In this ultrasound, the doctor can observe characteristics of the hydatidiform mole and identify its type, in addition to being able to visualize tecalutein cysts in the ovaries.
In addition to the ultrasound, another test that the doctor should order is beta-HCG, which in complete hydatidiform mole has very high levels, generally above 100,000 mIU/mL.
In partial hydatidiform mole, beta-HCG levels may be at normal values for gestational age or even below reference values. Check the reference values for beta-HCG.
Other tests that the doctor may order to evaluate symptoms are thyroid tests, complete blood count, kidney and liver function tests, blood clotting factors and lung X-rays.
Possible causes
Hydatidiform mole is caused by genetic changes during fertilization, resulting in an abnormal multiplication of placental cells.
Some factors can increase the risk of developing hydatidiform mole, such as:
- Pregnancy before the age of 20 or after the age of 35;
- Previous history of molar pregnancy;
- History of miscarriages or infertility;
- Smoking habit.
Furthermore, another factor that may increase the risk of hydatidiform mole is a diet low in carotenes, which are precursors of vitamin A.
Types of hydatidiform mole
Hydatidiform mole can be classified into two types, which are:
1. Complete hydatidiform mole
Complete hydatidiform mole is the most common type, caused by the fertilization of an egg without a nucleus, by two sperm or one sperm that then duplicates, causing the fertilized egg to have only the father’s DNA.
This type of hydatidiform mole is characterized by the absence of the fetus and amniotic fluid, a thick placenta with cysts, and a mass in the uterine cavity with a “snowstorm” appearance.
2. Partial hydatidiform mole
Partial hydatidiform mole is caused by the fertilization of a normal egg by two sperm.
In this type of hydatidiform mole, the fetus is formed, which presents malformations, in addition to being characterized by the presence of little amniotic fluid and a placenta with cysts, with an appearance similar to “Swiss cheese”.
How the treatment is carried out
Hydatidiform mole treatment must be carried out under the guidance of an obstetrician, and must be done as quickly as possible to remove the hydatidiform mole, and thus avoid complications.
The main treatments for hydatidiform mole are:
- Emptying the uterus, through uterine dilation and curettage. Find out how curettage is done;
- Hysterectomywhich is the removal of the uterus, especially in women over 40 or who already have children.
In addition, the doctor must monitor beta-HCG levels, and in the case of complete hydatidiform mole, the test must be carried out once a week or every 15 days, until values are normal or negative, after 3 tests. consecutive.
After obtaining negative beta-HCG results, medical follow-up must also be carried out, repeating the test once a month for 6 months.
In the case of partial hydatidiform mole, the beta-HCG test must be carried out 30 days after treatment.
However, in cases where beta-HCG levels remain high, which is indicative of persistent, invasive gestational trophoblastic disease or cancer, the doctor should refer the woman for consultation with an oncologist to begin chemotherapy treatment. . See the main types of gestational trophoblastic disease.
Can someone who has had hydatidiform mole get pregnant?
A woman who has had a hydatidiform mole can become pregnant after the disease is cured, and in the case of a complete hydatidiform mole, the obstetrician can allow her to become pregnant after 6 months with negative beta-HCG results.
In the case of partial hydatidiform mole, after 30 days of a negative beta-HCG result, the doctor may release the woman to become pregnant.
Possible complications
Hydatidiform moles can cause some complications such as:
- Pre eclampsia;
- Pulmonary embolism;
- Acute pulmonary edema.
These complications are serious and can put a woman’s life at risk, occurring mainly when hydatidiform mole treatment is not carried out quickly and the pregnancy progresses into the second trimester.
Furthermore, even after treatment, trophoblastic tissue can continue to proliferate and develop into gestational trophoblastic neoplasia, that is, cancer.
