Treatment
If the pregnancy has not ended on its own a suction D & C is usually used to evacuate the mole form the uterus. If a woman does not wish to continue with childbearing sometimes a hysterectomy is offered. Induction of labor is not recommended do to increased risks of hemorrhage.
On going treatment includes hCG levels to be taken several times a week, then weekly, until they are "normal" for three weeks. Then you will be tested monthly for six months, and every two months until a total of one year has passed. Pelvic exams should be done too. A rising level of hCG and an enlarging uterus could indicate a choriocarcinoma.
Pregnancy should be avoided for the period of one year. Any method of birth control, with the exception of an intrauterine device, is acceptable.
If you are Rh negative, then you will also receive the Rhogam shot.
Gestational Throphoblastic Disease (GTD) & Neoplasia (GTN)
This encompasses a range of problems that arise from a placental trophoblast.
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Weekly Pregnancy GuideFree personalized pregnancy guide, fetal development images, and more.www.pregnancyweekly.comGTN refers to persistent tissue found in follow up to a molar pregnancy that is assumed to be malignant.
GTN is one of the most curable cancers in the gynecology. This is a change from earlier years because of the increased number of treatments, personalized care, it's more easily detected, and its extremely sensitive to chemotherapy.
There are two groups, nonmesastatic and metastatic, meaning the the disease has spread to other parts of the body, most frequently the liver and the brain. If you do not have brain or liver involvement your chances of recovery are nearly 100%, you are in the low risk group. Metastasis in either of the two areas indicate that you are in the high risk group.
Only 15-30% of women with a molar pregnancy will need further treatment. The main sign that this might be necessary would be continued bleeding after a D & C. Although other signs include abdominal pain, ovarian enlargement, and signs of a metastasis include pulmonary symptoms (coughing, etc.).
Methotrexate can also be used to help excavate the uterus. (This is an injection that causes the tissues to die and be discharged from the vagina.)
Emotional Health
Losing a pregnancy at any stage can be hard, and even when there may technically be no baby to grieve due to the reactions of the cells involved. This means that there will have to be a healing time for all involved and the stages of grief will be experienced, though not necessarily in order or at the same time as your partner.
What makes this type of loss different from a "normal miscarriage" or loss is that you have the added concern of the mother's continued health, including the risk of cancer.
While the risks of a molar pregnancy repeating itself are very small, it is something that most couples will think about prior to conceiving again.
The time to wait for another conception is also longer than a standard waiting time after a miscarriage. This can add pressure and heart ache.
Counseling, support groups, journaling, anything you can do to get your emotions out are great. Look for local resources as well as resources online.
Attempting Pregnancy Again
Do you or don't you? This is not an easy question.
If you've previously had a molar pregnancy without complications, your risk of having another molar pregnancy are about 1-2%. These odds are less than having a second ectopic pregnancy (7-25%), so in that respect the answer is good.
Medically it will depend on many factors. So couples will choose to have genetic counseling prior to conceiving again. In the end it's up to you and your partner if you wish to try again.
There are many support systems available for subsequent pregnancies, including Pregnancy After Miscarriage List and Subsequent Pregnancy after Loss Mailing Lists. I highly encourage you to seek both medical and emotional support during these times.
Women at Risk
Early Teens
Over 40 years
Clomiphene stimulation
1-2% chance of a second mole
วันจันทร์ที่ 3 กันยายน พ.ศ. 2550
Molar preg Treatment
If the pregnancy has not ended on its own a suction D & C is usually used to evacuate the mole form the uterus. If a woman does not wish to continue with childbearing sometimes a hysterectomy is offered. Induction of labor is not recommended do to increased risks of hemorrhage.
On going treatment includes hCG levels to be taken several times a week, then weekly, until they are "normal" for three weeks. Then you will be tested monthly for six months, and every two months until a total of one year has passed. Pelvic exams should be done too. A rising level of hCG and an enlarging uterus could indicate a choriocarcinoma.
Pregnancy should be avoided for the period of one year. Any method of birth control, with the exception of an intrauterine device, is acceptable.
If you are Rh negative, then you will also receive the Rhogam shot.
On going treatment includes hCG levels to be taken several times a week, then weekly, until they are "normal" for three weeks. Then you will be tested monthly for six months, and every two months until a total of one year has passed. Pelvic exams should be done too. A rising level of hCG and an enlarging uterus could indicate a choriocarcinoma.
Pregnancy should be avoided for the period of one year. Any method of birth control, with the exception of an intrauterine device, is acceptable.
If you are Rh negative, then you will also receive the Rhogam shot.
Molar preg
The uterus is rather filled with the mole that resembles a bunch of grapes. The fluid filled vesicles grow rapidly, which can make the uterus seem larger than it should be for gestational age. Because there is no placenta to receive the blood typically you will see bleeding into the uterine cavity or vaginal bleeding.
Partial Mole
This most frequently occurs when two sperm fertilize the same egg. There may be partial placentas, membranes or even a fetus present in a partial mole. However, there are usually genetic problems with the baby. Rarely, a partial mole will exist with twin pregnancy, however, the other twin rarely survives.
Symptoms
Symptoms include:
Increased nausea and vomiting
Vaginal bleeding
Increased hCG levels
Rapidly growing uterus
Pregnancy induced hypertension prior to 24 weeks
No fetal movement or heart tone detected
Hyperthyroidism
Pulmonary Embolization
Diagnosis
Most of the time a molar pregnancy will spontaneously end. When the woman passes tissues that appear to be grape like and shows them to her practitioner then a molar pregnancy is suspected.
Ultrasound can also help determine a molar pregnancy. When doing an ultrasound one sees a “snow storm effect" on the screen.
Serial hCG levels can show a rapid rise in hCG that may indicate that further study is needed
Partial Mole
This most frequently occurs when two sperm fertilize the same egg. There may be partial placentas, membranes or even a fetus present in a partial mole. However, there are usually genetic problems with the baby. Rarely, a partial mole will exist with twin pregnancy, however, the other twin rarely survives.
Symptoms
Symptoms include:
Increased nausea and vomiting
Vaginal bleeding
Increased hCG levels
Rapidly growing uterus
Pregnancy induced hypertension prior to 24 weeks
No fetal movement or heart tone detected
Hyperthyroidism
Pulmonary Embolization
Diagnosis
Most of the time a molar pregnancy will spontaneously end. When the woman passes tissues that appear to be grape like and shows them to her practitioner then a molar pregnancy is suspected.
Ultrasound can also help determine a molar pregnancy. When doing an ultrasound one sees a “snow storm effect" on the screen.
Serial hCG levels can show a rapid rise in hCG that may indicate that further study is needed
Molar Pregnancy
A molar pregnancy refers to a pregnancy that is a type of gestational trophoblastic disease. It can refer to either a complete or a partial mole. Throughout the United States and Europe the incidence is about 1/1000 and 1/2000 pregnancies. Although it is much more common in areas such as Southeast Asia and Mexico.
We still do not know exactly why a molar pregnancy occurs. It is believed to be a nutritional deficit like protein or carotene. It can also be caused by a ovular (ovulation) defect.
Complete Mole
This occurs when the nucleus of an egg is either lost or inactivated. The sperm then duplicates itself because the egg was lacking genetic information. Usually there is no fetus, no placenta, no fluid and no amniotic membranes.
We still do not know exactly why a molar pregnancy occurs. It is believed to be a nutritional deficit like protein or carotene. It can also be caused by a ovular (ovulation) defect.
Complete Mole
This occurs when the nucleus of an egg is either lost or inactivated. The sperm then duplicates itself because the egg was lacking genetic information. Usually there is no fetus, no placenta, no fluid and no amniotic membranes.
25 Signs of Pregnancy and Pregnancy Symptoms
If you're like everyone else you're trying to figure out what the signs of pregnancy or pregnancy symptoms are and how likely they are to mean that you are pregnant. You can ask other people, you can worry in silence, but the best thing is to read through the categories and add up the signs. The more you have the more likely you are to be pregnant.
On the chart below are 25 of the most common signs of pregnancy and what they mean. You can also click the sign to get more information on each sign of pregnancy. The three categories of pregnancy signs are: possible, probable and positive.
On the chart below are 25 of the most common signs of pregnancy and what they mean. You can also click the sign to get more information on each sign of pregnancy. The three categories of pregnancy signs are: possible, probable and positive.
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