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Molar pregnancy and gestational trophoblastic disease

Mola hydatidosa; neoplasia trophoblastica gestationis · Mola hydatidosa a gestační trofoblastická nemoc

female only

What it is

An abnormal fertilisation grows placental tissue instead of a baby; rarely it becomes choriocarcinoma, a cancer chemotherapy cures in nearly every case.

Symptoms & signs

  • Bleeding in early pregnancy
  • severe vomiting
  • womb larger than the dates
  • very high hCG
  • no heartbeat on the scan
  • breathlessness or cough if it spreads

🚩 Get help if…

  • call 112 / 911 now Heavy bleeding from the vagina in early pregnancy
  • call 112 / 911 now Severe belly pain, fainting or breathlessness
  • see a doctor soon Severe vomiting or a womb bigger than expected
  • see a doctor soon Bleeding or a rising pregnancy test weeks after treatment

Where it strikes

Medical treatment

  • Ultrasound and hCG level
  • suction evacuation of the womb
  • weekly hCG checks until normal
  • methotrexate or actinomycin D if hCG stays high
  • combination chemotherapy (EMA-CO) for choriocarcinoma

Natural & lifestyle

  • Reliable contraception during follow-up
  • registration with a specialist centre
  • folic acid before the next pregnancy

Emerging & experimental

  • Immunotherapy (pembrolizumab, avelumab) for resistant disease
  • genetic testing for repeated moles (NLRP7)

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Herbal or dietary 'cleanses' after a mole — untested; hCG follow-up is what keeps women safe anecdotal / traditional
  • Fertility herbs to 'prepare the womb' before trying again — untested; wait for hCG to give the all-clear anecdotal / traditional

ICD codes