PREGNANCY-BIRTH Messages for February, 1999: Re: partial molar pregnancy

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Re: partial molar pregnancy

From: William D. McIntosh, MD (anonymous@obgyn.net)
Mon, 22 Feb 1999 22:49:34 -0600 (CST)

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In reply to: Mary: "partial molar pregnancy"

At Mon, 22 Feb 1999, Mary wrote: >
>On December 8, 1998, I had a miscarriage, which was right around my 9th
>week of pregnancy. I had been having problems from the beginning of the
>pregnancy with spotting and light cramping. Prior to the miscarriage I
>had three ultrasounds and number visits for blood to be drawn. My
>doctor thought that I had normal spotting that was probably due to
>implantation and I was told to rest. Well, as I began heavy bleeding I
>went in for another exam. This was when I was told I had miscarried.
>They did a D&C, at my request, and I was told to come in four weeks
>later. When I went back after four weeks, the doctor told me after my
>next period started I could try to get pregnant again. I then asked how
>the lab results turned out. He said he did not know and would check on
>them. Two weeks later he called and told me and explained briefly that
>I had had a partial molar pregnancy and to come in for blood work, once
>a week for a month. I came in for blood work as told for three weeks
>and was told everything was fine and I could get pregnant. My husband
>was concerned and his aunt, who is a doctor (not a ob-gyn), also
>expressed her concern. The aunt felt I should inquire again about
>whether pregnancy is wise at this time. After a lot of run around, the
>doctor's nurse said I should wait 6 months, and before trying come in
>for a hcg (?) blood check. I'm not sure whether my doctor is familiar
>with a molar pregnancy. I have read where you should wait a minimum of
>12 months. I have seen my doctor for regular exams for several years,
>and I have always been satisfied with his care, yet I am unsure latly as
>to whether or not he is the best person to consult at this point. Am I
>overly worried, or should I consult another doctor? How is the follow up
>treatment suppose to go for a molar pregnancy? Please let me know
>something. Thank you.

Generally, no treatment is needed after a D&C. You should track your HCG level down to 0 or near 0, and then opinions diverge. Some authorities say that you can try to get pregnancy again at that point (with close follow-up and early serial U/S), others suggest waiting from 3-6 months. I try to match the wait to the situation. A 22 year old, and a 39 year old are different patients, and should be managed differently.

Sometimes, the HCG level does not return to 0. This is a much more serious condition, a malignant condition that requires chemotherapy. In that case, after treatment is complete, I do request that the patient wait at least one full year (from the time the HCG is finally 0) before she tries to become pregnant.

-- William D. McIntosh, MD Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

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