Molar Pregnancy: Concerns and Next Steps After Diagnosis

Inquire about hydatidiform mole?

Hello doctor, I had a molar pregnancy removed in early June and underwent weekly blood tests for a month.
The doctor said my levels have returned to normal.
However, I am pregnant again! On September 25, the examination indicated that I am 7 weeks pregnant.
The ultrasound showed that the placenta looks normal, but I am experiencing bleeding.
The doctor did not perform any additional tests and only advised me to terminate the pregnancy.
Is it true that I cannot continue with this pregnancy? If I cannot continue, will the second miscarriage procedure be out-of-pocket? Will the doctor still provide follow-up care?

Xiao Xiao Yuan, 30~39 year old female. Ask Date: 2015/09/27

Dr. Lin Manying reply Obstetrics and Gynecology

Hello, if you have a history of molar pregnancy, it is recommended not to conceive again within a year, as the risk of another molar pregnancy is high, and it may potentially progress to choriocarcinoma.
Generally, it is advised not to become pregnant within a year.
For questions regarding health insurance coverage, please consult the physician who performed the surgery.
If you meet the criteria for induced abortion, health insurance benefits may apply.

Reply Date: 2015/09/27

More Info

Molar pregnancy, also known as hydatidiform mole, is a type of gestational trophoblastic disease that arises from abnormal fertilization of an egg. It can lead to complications, including the risk of persistent gestational trophoblastic disease (GTN) if not managed properly. Your situation, having had a molar pregnancy in June and now being pregnant again, understandably raises concerns.

Firstly, it’s important to understand that after a molar pregnancy, close monitoring is essential. The fact that your hCG levels returned to normal is a positive sign, indicating that the molar tissue has been cleared. However, the subsequent pregnancy requires careful evaluation due to the history of the molar pregnancy.
The bleeding you are experiencing during this new pregnancy can be concerning. While some bleeding can occur in normal pregnancies, it is crucial to differentiate between benign causes and potential complications. The fact that your ultrasound showed a normal placenta is reassuring, but bleeding can still indicate issues such as a threatened miscarriage, placental abruption, or other complications.
Regarding your question about whether the pregnancy can be maintained, it largely depends on the underlying cause of the bleeding and the overall health of the pregnancy. If the bleeding is due to a benign cause and the fetus is developing normally, there may be a chance to continue the pregnancy. However, if there are signs of complications or if the bleeding is significant, your healthcare provider may recommend termination for your safety and health.

As for the financial aspect of a potential second termination, this can vary based on your healthcare provider, insurance coverage, and local regulations. It’s essential to discuss these concerns with your healthcare provider or the administrative staff at your clinic to understand your options and any potential costs involved.

In terms of follow-up care, after a molar pregnancy, most healthcare providers will continue to monitor hCG levels closely in subsequent pregnancies to ensure that there is no recurrence of molar tissue. If you do have to undergo another procedure, your doctor should continue to provide follow-up care to monitor your recovery and any future pregnancies.

In summary, your situation requires careful monitoring and open communication with your healthcare provider. It’s crucial to express your concerns about the bleeding and seek further evaluations if necessary. Understanding the risks and having a clear plan moving forward will help you navigate this challenging time. Always prioritize your health and well-being, and don’t hesitate to seek a second opinion if you feel uncertain about the recommendations you are receiving.

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