Diagnosis and treatment of molar pregnancy in a 49 year old woman

HanoiMs. Hoa, 49 years old, late menstruation, nausea, pregnancy test results with two lines but the doctor diagnosed a molar pregnancy.

MSc. Dr. Duong Ngoc Hung, Tam Anh Cau Giay General Clinic, said that Ms. Hoa had a complete molar pregnancy, meaning there was no embryo but the entire placenta turned into fluid sacs. Her beta-hCG test result was about 258,000 mIU/mL, unusually high compared to the progression of pregnancy in the early stages (usually not more than 100,000 mIU/ml). Ultrasound showed that there were many small and dense structures in the uterine cavity.

Ms. Hoa is old and has given birth to many children. After assessing the patient's condition and wishes, Dr. Hung performed a complete hysterectomy, preserving both ovaries. This option helps remove the egg mass in the uterus, while reducing the risk of recurrence.

The surgical team noted that the patient's uterus was as large as a three-month fetus, with many degenerated placental tissues inside. Ms. Hoa recovered stably and was discharged from the hospital after a week.

According to Dr. Hung, molar pregnancy is a condition in which placental tissue develops abnormally in the uterus. Instead of forming a normal placenta to nourish the fetus, the placenta swells, forming many small pockets of fluid. The patient may have pregnancy-like signs such as delayed menstruation, nausea, or two-line pregnancy test, but the pregnancy does not develop normally.

Most cases of molar pregnancy are benign if properly treated and monitored. However, some cases may progress to trophoblastic disease that persists after treatment. When trophoblastic cells continue to grow, invade the uterine muscle or spread to other organs, the rate of progression to trophoblastic cancer occurs.

Treatment for molar pregnancy depends on the patient's age, medical condition, risk of complications and needs. For young women who still want to have children, doctors often prioritize oocyte aspiration, then periodically monitor beta-hCG until the index returns to normal and stable.

According to Dr. Hung, the molar pregnancy rate ranges from 1/500 to 1/1,000 pregnancies. The disease can occur in all women of reproductive age, the risk is higher in those who become pregnant when they are too young or over 40, have had a molar pregnancy, have had multiple miscarriages or have some other risk factors.

Doctors recommend that women of reproductive age who have signs similar to pregnancy should see an Obstetrician and Gynecologist early to determine whether they are pregnant or not, and to early detect abnormalities such as ectopic pregnancy, stillbirth, and molar pregnancy.

Van Anh

*Patient's name has been changed