Hydatidiform Mole: Causes, Symptoms, Diagnosis, Treatment, and Prevention
The Hydatidiform Mole is a rare condition that occurs when an abnormal mass of tissue grows within the uterus rather than during pregnancy. It is also known as a molar pregnancy or a gestational trophoblastic disease. It can cause bleeding, vomiting, and other complications during pregnancy. A hydatidiform mole needs to be removed immediately to avoid further complications.
Causes of Hydatidiform Mole
Hydatidiform mole is caused by a problem with the fertilization of the egg by the sperm. There are two types of hydatidiform mole: complete and partial.
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A complete hydatidiform mole forms when a fertilized egg (without any genetic material) contains only the father's chromosomes and no fetal tissue. It grows into fluid-filled cysts that look like grapes.
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The partial hydatidiform mole occurs when a normal egg is fertilized by two sperm or one sperm that duplicates itself. The resulting tissue contains an extra set of chromosomes and some fetal tissue, which grow into an abnormal placenta and a malformed fetus that cannot survive.
The exact cause of hydatidiform mole is unknown, but some factors that may increase the risk are:
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Age: Women who are younger than 20 or older than 40 are more likely to have a hydatidiform mole.
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History: Women who have had a previous hydatidiform mole or a miscarriage are more likely to have a hydatidiform mole.
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Ethnicity: Women of Asian descent are more likely to have a hydatidiform mole.
Symptoms of Hydatidiform Mole
The symptoms of hydatidiform mole may vary depending on the type and the stage of the condition. Some of the common symptoms are:
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Vaginal bleeding, often dark brown or bright red in color.
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Severe nausea and vomiting, resembling hyperemesis gravidarum.
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Pelvic pain or pressure.
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Anemia or low blood count.
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Hyperthyroidism or overactive thyroid gland.
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High blood pressure or preeclampsia.
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Uterine enlargement larger than expected for gestational age.
Diagnosis of Hydatidiform Mole
The diagnosis of hydatidiform mole is based on the medical history, the physical examination, and the results of some tests. Some of the tests that may be used to diagnose or confirm hydatidiform mole are:
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Ultrasound is a form of imaging that uses sound waves to create an image of the uterus and fetus. Ultrasound can detect hydatidiform moles as early as the first trimester by showing the shape and size of the mass and the absence of a heartbeat.
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During pregnancy, human chorionic gonadotropin (hCG) is produced by the placenta, and women with hydatidiform moles have higher levels of hCG than normal.
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An hydatidiform mole can be diagnosed through a biopsy taken from the uterus and examined under a microscope. A biopsy can also rule out other conditions that can cause similar symptoms, such as an ectopic pregnancy or a miscarriage.
Treatment of Hydatidiform Mole
The treatment of hydatidiform mole involves removing the abnormal tissue from the uterus as soon as possible to prevent further complications. The main methods of treatment are:
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Dilation and curettage (D&C), which is a procedure that uses a thin instrument to scrape out the tissue from the uterus. This is the most common method of treatment for hydatidiform mole. It is usually done under general anesthesia or sedation.
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Suction evacuation, which is a procedure that uses a vacuum device to suck out the tissue from the uterus. This is a less invasive method of treatment for hydatidiform mole. It can be done under local anesthesia or sedation.
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Hysterectomy, which is a surgery that removes the entire uterus. This is a rare method of treatment for hydatidiform mole. It is usually reserved for women who have completed their childbearing or who have a high risk of developing cancer from the hydatidiform mole.
After the treatment, the woman needs regular follow-up visits and blood tests to monitor the level of hCG. Within a few weeks or months of treatment, the level of hCG should drop to zero. It is possible that some tissue still remains in the uterus or has spread to other parts of the body if the level of hCG doesn't drop or rise again. This is a serious complication that requires further treatment.
Prevention of Hydatidiform Mole
There is no sure way to prevent hydatidiform mole, as it is a random event that occurs during conception. However, some measures that may help reduce the risk or the severity of hydatidiform mole are:
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Waiting for at least six months to one year before trying to conceive again after having a hydatidiform mole. This allows the body to recover and the hCG level to return to normal.
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Taking folic acid supplements before and during pregnancy, as recommended by the doctor. Folic acid is a vitamin that is essential to the development of the neural tube, which is the precursor of the brain and spinal cord. A deficiency of folate can lead to neural tube defects, including spina bifida or anencephaly, which are sometimes associated with hydatidiform moles.
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Avoiding smoking, drinking, or using drugs during pregnancy, as these substances can interfere with the normal development of the fetus and the placenta and increase the risk of hydatidiform mole or other complications.
