Molar pregnancy, popularly known as grape pregnancy, is a type of disease that originates from the placenta and the cells that make up its membrane during embryonic development. In a mole pregnancy, the protrusions that connect the placenta to the lining of the uterus, called chorionic villi, do not develop properly. This causes a mass called a hydatiform to form in the uterus instead of a baby. Hydatiform is a tumor of placental tissue caused by abnormal chromosomes in a fertilized egg. A mole pregnancy occurs when two sets of chromosomes from the father combine with one set of chromosomes from the mother during fertilization, or when the mother receives no chromosomes at all.
There are 2 types of molar pregnancy: complete and incomplete. A pregnancy with complete hydatiform has 46 chromosomes but no embryo. All chromosomes come from the father. Fetal circulation in the blood vessels does not develop and the placental cells enlarge and swell. In a complete molar pregnancy, there is no baby development. In incomplete hydatiform, abnormal trophoblast cells are present along with a baby with growth retardation and anomalies.
Molar pregnancies usually have the same symptoms as a healthy pregnancy. Some of the symptoms of mole pregnancy are as follows:
A mole pregnancy is diagnosed by ultrasound. The expectant mother also has a very high level of the pregnancy hormone bhCG. Treatment of molar pregnancy is two-stage. In the first stage, the uterus is emptied. The second phase is the follow-up phase. The earlier a mole pregnancy is detected and the uterus is evacuated, the lower the risk of the procedure. Most molar pregnancies can be detected within a few weeks of fertilization. The procedure is different from a normal abortion, so it is extremely important that it is performed by an experienced doctor. In rare cases, complete removal of the uterus may also be necessary, taking into account the patient’s age, risk factors and complete family.
Since a mole pregnancy has the possibility of malignancy, i.e. cancer, it needs to be followed up. Pregnancy is prohibited for at least 1 year after a mole pregnancy. At 2-week intervals, bhCG is measured in the blood. After normalization of blood levels, bhCG levels are measured monthly for 6 months and then every 2 months for at least 6 months. If the levels remain normal during this period, the follow-up is terminated and pregnancy is allowed.
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