WOMENS-HEALTH Messages for June, 1998: Re: WAITING PERIOD AFTER PARTIAL MOLAR PREGNANCY

Re: WAITING PERIOD AFTER PARTIAL MOLAR PREGNANCY

From: anonymous@obgyn.net
Wed, 10 Jun 1998 22:28:21 -0500 (CDT)

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At Wed, 10 Jun 1998, TINA wrote:

THE DOCTORS >AT THE HOSPITAL TOLD ME THAT AFTER MY HCG
>LEVELS RETURN TO NORMAL AND STAY THAT WAY
>FOR 2 MONTHS THAT I CAN TRY AGAIN. MY REGULAR DOCTOR SAYS I NEED TO
>WAIT 1 FULL YEAR AFTER MY HCG LEVELS GO TO ZERO.

First of all, I'm sorry about your loss. Molar pregnancies are difficult to understand. It's not like they're covered in 8th grade health class. Basically, a molar pregnancy is an abnormality of the egg/sperm combination that leads to an abnormal placenta (afterbirth). It is extremely rare that a molar pregnancy coincides with a normal pregancy. In your case, your baby had triploidy, which, of course, is not a normal condition and means the baby cannot survive. The recurrence risk for a molar pregnancy is about 1/100 (1%).

Molar pregnancies are usually treated with a D&C (gentle scraping of the uterine lining under anesthesia). Afterwards, it is critical to follow HCG levels, at least every month. Most textbooks advise following HCG levels for 1 year until attempting pregnancy again. However, scientific evidence for this is scarce. Some experts are suggesting a 6 month waiting period. However, I have never met a gynecologist who advises waiting only a few months, because there is a danger of confusing a normal, brand new pregnancy with a recurrence of a molar pregnancy. Molar pregnancies can recur even many months after they are removed. In these cases, further treatment with chemotherapy is necessary, as the molar pregnancy can act like a cancer, spreading to the lungs, brain, vaginal area, and bones. If you became pregnant too soon, your doctors would probably want to do another D&C, and give chemotherapy, which might actually abort a viable, normal pregnancy.

So, the advice to wait 6-12 months is considered worthwhile by the majority of ob/gyns I know (myself included).

I wish you the best of luck in the future.

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, Florida

The above information is provided for medical education only, and is not intended as specific medical advice. I am sorry, but due to time constraints, I am unable to answer personal e-mail.

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