Posts Tagged ‘molar pregnancy’

Bleeding during pregnancy – what does it mean?

Monday, July 6th, 2015

bleeding during pregnancyIf you are pregnant and experience spotting or bleeding, it can be very scary. When you see blood, your first thought may be “is my baby ok?” Bleeding and spotting from the vagina during pregnancy is common. Up to half of all pregnant women have some bleeding or spotting.

Bleeding? Spotting? What’s the difference?

Spotting is light bleeding and happens when you have a few drops of blood in your underwear. Bleeding is a heavier flow of blood, enough that you need a panty liner or pad to keep the blood from soaking your underwear or clothes.

Bleeding in early pregnancy

Bleeding doesn’t always mean there’s a problem, but it can be a sign of serious complications. There are several things that may cause bleeding early in your pregnancy, such as having sex, an infection, or changes in your cervix and hormones. You may bleed a little when the embryo attaches to the lining of your uterus (called implantation bleeding). This may occur 10-14 days after fertilization. Although this spotting is usually earlier and lighter than a menstrual period, some women don’t notice the difference, and don’t even realize they’re pregnant.

Sometimes bleeding and spotting in the first trimester can be a sign of a serious problem such as miscarriage, ectopic pregnancy, or molar pregnancy. But keep in mind that bleeding doesn’t always mean miscarriage. At least half of women who have spotting or light bleeding early in pregnancy don’t miscarry.

Bleeding in late pregnancy

Causes of late pregnancy bleeding include labor, sex, an internal exam by your provider or problems with your cervix, such as an infection or cervical insufficiency. It could also be a sign of preterm labor, placenta previa, placental abruption or uterine rupture.

How to tell if the bleeding is dangerous

Bleeding or spotting can happen anytime, from the time you get pregnant to right before you give birth. Bleeding can be a sign of a serious complication, so it’s important you call your prenatal care provider if you have any bleeding or spotting, even if it stops. If the bleeding is not serious, it’s still important that your provider finds out the cause. Do not use a tampon, douche or have sex if you’re bleeding.

Before you call your provider, write down these things:

• How heavy your bleeding is. Is it getting heavier or lighter and how many pads are you using?
• The color of the blood. It can be different colors, like brown, dark or bright red.

Go to the emergency room if you have:

• Heavy bleeding
• Bleeding with pain or cramping
• Dizziness and bleeding
• Pain in your belly or pelvis

Treatment for your bleeding depends on the cause. You may need a medical exam or tests performed by your provider.

Bottom Line

If you are bleeding or spotting at any point in your pregnancy, call your provider right away and describe what you are experiencing. It’s important that your bleeding or spotting is evaluated to determine if it is dangerous to you and your baby.

What is a molar pregnancy?

Thursday, August 1st, 2013

In a molar pregnancy, the early placenta develops into an abnormal mass (called a hydatidiform mole) that looks a little like a bunch of white grapes. The embryo either does not form at all or is malformed and cannot survive. About 1 in 1,500 pregnancies is molar.

There are two types of molar pregnancy: complete mole (there is no embryo and no normal placental tissue); and partial mole (there is an abnormal embryo, and there may be some normal placental tissue.) Both types of molar pregnancy are caused by an abnormal fertilized egg.

In a complete mole, all of the fertilized egg’s chromosomes (tiny thread-like structures in cells that carry genes) come from the father. Normally, half come from the father and half from the mother. In a complete mole, shortly after fertilization, the chromosomes from the mother’s egg are lost or inactivated, and those from the father are duplicated.

In most cases of partial mole, the mother’s 23 chromosomes remain. However, there are two sets of chromosomes from the father (so the embryo has 69 chromosomes instead of the normal 46). This can happen when two sperm fertilize an egg.

Molar pregnancy poses a threat to the pregnant woman because it can occasionally result in rare pregnancy-related types of cancers called invasive mole and choriocarcinoma.

The most common symptom of a molar pregnancy is abnormal vaginal bleeding in the first three months of pregnancy. Other symptoms may include severe nausea and vomiting, rapid uterine growth, high blood pressure, cysts (fluid-filled sacs) on the ovaries, and hyperthyroidism.

Health care providers use an ultrasound to diagnose a molar pregnancy. The provider also measures the levels of the hormone hCG in the mother’s blood, which often are higher than normal with a molar pregnancy.

A molar pregnancy is a frightening experience. Not only does the woman lose a pregnancy, she learns that she has a slight risk of developing cancer. To protect her, all molar tissue must be removed from the uterus. This usually is done with a D&C. Occasionally, when the mole is extensive and the woman has decided against future pregnancies, she may have a hysterectomy.

After mole removal, her provider again measures the level of hCG. If it has dropped to zero, the woman generally needs no additional treatment. However, the provider will continue to monitor hCG levels for 6 months to 1 year to be sure there is no remaining molar tissue. It’s important that a woman not become pregnant during this time, because a pregnancy would make it difficult to monitor hCG levels.

After the uterus is emptied, about 20 percent of complete moles and less than 5 percent of partial moles continue on. The remaining abnormal tissue may continue to grow in the wall of the uterus. This is called persistent gestational trophoblastic disease (GTD) or invasive mole. The diagnosis is made when hCG blood levels stop decreasing or begin to increase. Treatment with one or more cancer drugs cures persistent GTD nearly 100 percent of the time. Rarely, a cancerous form of GTD, called choriocarcinoma, develops and spreads to other organs. Use of multiple cancer drugs is usually very successful at treating this cancer.

All of this may sound scary, but the good news is that a woman who has had molar pregnancy usually can go on to have healthy pregnancies. The risk that a mole will develop in a future pregnancy is only about 1 to 2 percent.

Pregnancy after a loss

Tuesday, May 4th, 2010

flowerLosing a baby is something no parent should have to face but, sadly, it does happen to some people. After a baby dies, some parents want to try to get pregnant again as soon as possible, while others want to wait.  Some are afraid to try again because they are worried about losing another baby.  Some are very angry.  I think most couples go back and forth between wanting and not wanting to get pregnant again.

If this has happened to you, ask yourself how you feel about getting pregnant again.  Talk to your partner about your feelings and ask him how he feels.  He may feel differently, so share your concerns and make a plan that supports both of you.

Ask your provider when it’s OK for you to start trying for another pregnancy. Some women are told to wait at least 18 months before getting pregnant again.  This gives your body enough time to heal and your emotions time to settle.  But not all women can wait that long because of their age or other factors.  So, talk with your provider about your medical history and make a plan that’s best for you.  Be sure to get a preconception checkup with your provider, too, to make sure you’re as healthy as possible.  You’ll want to be taking a good multivitamin with at least 400 mcg of folic acid each day.

The March of Dimes has created bereavement materials available at no charge for parents or other family members who have experienced the loss of a baby between conception and the first month of life.  These include different fact sheets, three booklets (From Hurt to Healing; What Can You Do?, and When You Want to Try Again), and a list of grief resources.  They are available in English and Spanish.  You can read about some of these materials and order a free kit on our website.