Complications associated with a molar pregnancy include anemia because of blood loss, severe high blood pressure, an overactive thyroid gland, heart failure, hemorrhage, infection and acute pulmonary failure.
Standard Treatment As soon the diagnosis is made, a therapeutic suction dilatation and curettage (D&C) is performed in the operating room under anesthesia. For women who have completed childbearing, the removal of the uterus and cervix (a hysterectomy) is also an option.
Rhogam is given to women with Rh negative blood to prevent Rh sensitization. In about a third of women with a molar pregnancy, there may be enlargement of one or both ovaries because of multiple (thecolutein) cysts caused by the high levels of ßHCG. Occasionally the cysts can rupture, bleed or become infected. In the vast majority of cases, these cysts do not have to be surgically removed because they resolve with time, although sometimes it can take several weeks or months for them to disappear completely.
Chemotherapy may be given after the removal of the mole if there is a tissue diagnosis of choriocarcinoma , if the serum ßHCG rises for two successive weeks or plateaus for three weeks or more (in the vast majority of women, the ßHCG level plateaus or rises by seven weeks after the D&C), if metastases are found, if the serum ßHCG rises again after reaching a normal level or if there is a hemorrhage not related to an incomplete D&C.
