Monday, October 27, 2014

When Good Pregnancies are Misdiagnosed as Molar Pregnancies

Every so often on The Misdiagnosed Miscarriage, women share that their doctors have diagnosed a molar pregnancy and are pushing for a quick D&C.

Now, a molar or partial molar pregnancy is quite serious.   A molar pregnancy is when the mother's chromosomes are somehow 'lost' and the father's chromosomes are duplicated.  In a partial molar pregnancy, the father's chromosomes are duplicated again but the mother's remain as well.  This can happen with duplication or if two sperm fertilize the egg.

According to the Mayo Clinic, about 20% of women who have had a molar pregnancy will develop gestational trophoblastic disease.  This happens when the tissue remains and continues to grow.  You'll see hCG levels rise as well.  When this happens, chemotherapy may be needed.  Very rarely this will turn into cancer.  Generally, a complete molar pregnancy can be detected by about nine weeks. 

As you can see, you should take a molar pregnancy but I was reminded today of how frequently good miscarriages are misdiagnosed as being molar as in Gabrielly's story.  We've been emailing back and forth.  She was being misdiagnosed too soon with a molar pregnancy.  We've had other similar stories as well, such as Heather's story and Dani's story. 

I have a suspicion that some doctors *may* use the molar diagnosis to pressure women into having a quick D&C.   Very few pregnancies have ended up being molar in my years on the site.  Those women seemed to have really high hCG levels (over 100,000) or other signs (i.e. grapelike clusters, pain, bleeding, etc...).  Reading through online literature and it sounds like partial molar and molar pregnancies are often caught at the end of the first trimester and into the second trimester. 

How early can a molar pregnancy be caught?  This is what I've really been wondering since so many women who are being misdiagnosed with a molar pregnancy seem to be between 6-8 weeks.

I found this study:

A prospective study of ultrasound screening for molar pregnancies in missed miscarriages.

"The diagnosis of both complete (CHM) and partial (PHM) hydatidiform moles in first-trimester miscarriages is difficult. hCG is significantly higher in both CHM and PHM and, in conjunction with transvaginal ultrasound, could provide the screening test required to enable clinicians to counsel women more confidently towards non-surgical methods of management of their miscarriage, where histopathological examination is not available."

For this reason, if there is any reason to suspect your doctor is wrong in their diagnosis, you really might want to consider a second opinion especially during the first trimester.  Stay monitored though.

As always (((hugs))) if you are going through this scare.
 

18 comments:

  1. I would suggest everyone to get a second opinion just to be safe. I have used a second opinion service https://secondopinions.com a few times and will continue to do so. For the time and price its well worth it. Very professional and saved me a bunch of money.They also gave me a coupon code to share “sy15" to take 15% off your entire order which should still work. I recommend getting a second opinion because it can potentially save your life.

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  3. I was in the ER today with a similar diagnosis. My HCG has been monitored and rising appropriately for the last week and a half, however I have been spotting for several days and had some odd discharge (great/creamy tissue?) yesterday.

    At the ER they told me there is "no intrauterine pregnancy" and instead is an "abnormal pregnancy which is not characteristic of a molar pregnancy." They found a mass surrounded by fluid. They were pushing D&C ASAP. I have scheduled with an OB tomorrow.

    I am only 6 weeks 2 days, and would also like to get a second opinion. I was crushed by hearing what I did, but this site gives me some possible hope... I agree that it's odd on the timing of all of these.

    Thank you.

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  4. I think a second opinion is a really good idea. Let us know what you find out. (((hugs)))

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  5. Hi. I'm four weeks pregnant. I got some cramping around two weeks ago. I went I to my a and e they have told me first it's a molar pregnancy and they needed to terminate. Ten minutes later the doctor told me to come back in five days later. I'm not sure if the doctor or the gyno really know what's up. Any advice?

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  6. Hi. I'm four weeks pregnant. I got some cramping around two weeks ago. I went I to my a and e they have told me first it's a molar pregnancy and they needed to terminate. Ten minutes later the doctor told me to come back in five days later. I'm not sure if the doctor or the gyno really know what's up. Any advice?

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    1. I've not run into anybody diagnosed with a molar pregnancy this early before. I think you need to get a second opinion. Please, keep us updated.

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    2. Hapi- what did you find out? i know im super late into this post, but im in the same exact boat. :(

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  7. I actually just went through this and I'm one of the rare success stories. On Friday the 15th I went to the emergency room because I had a sharp pinching pain on my right side and feared an ectopic pregnancy. I had had normal blood work, even in the er my blood work was still in the normal range and doubling every 48 hours (or even less). I had an ultrasound done that rules out an ectopic, but they were also unable to see a intrauterine pregnancy either. What they did see was a heterogeneous cluster of cystic-like structures. I was diagnosed with a complete molar pregnancy as no gestational sac could be seen. After suffering through a stillbirth at 25 weeks in October with no known cause this came as a huge blow to us. This was going to be our rainbow baby. The next day We went to a different er for another opinion. This was all during the weekend so no obgyns were open. They ran the same tests that the previous doctor had, my blood work was still normal, but this time it got even worse. My uterine lining was asymmetrical and very very thick. They found a cyst on each of my ovaries and a 5mm cyst in my uterus. I was now diagnosed with adenomyosis as well as a possible molar. This doctor however was unsure about the molar because he agreed that my hcg levels were too low and he began to voice concern over choriocarsinoma.. A cancer of the uterus that causes thick lining and rising hcg levels. We were devastated. No gestational sac was visible anywhere. Monday morning I was finally able to contact my obgyn who couldn't believe no-one had called her sooner. I was in her office 3 hours later meeting with a surgeon and a doctor ready in case I needed emergency surgery. I had another ultrasound, this time with the doctor in the room. They started the ultrasound... And there was the sac! And on top of that there was even a yolk! The cysts on my ovaries the doctor had seen? They were left over from when my ovaries had released the follicles. The one on my left (which had shown up during my first pregnancy that we lost) was left over from my daughter that was stillborn, and the one on my right was from the new baby. And the adenomyosis? It is still a possible concern, but even if I do have it, it looks a whole lot worse than it could be right now because during pregnancy your veins in the uterus swell and the lining around the gestational sac thickens. I was so happy I cried and the doctor have me a huge hug. The ultrasound dated me at just 4 weeks and 4 days. I go back a in 11 days to check for a fetal pole and a heartbeat. Even is this pregnancy doesnt make it, We are incredibly blessed that we went from a complete molar/adenomyosis/possible choriocarsinoma, to a healthy normal pregnancy. In the three days Of hell I went through thinking the worst I did so much research and read so many case studies and talked to so many mothers who have been through molar pregnancies that I know now what to look for and expect for in the future. Losing a baby whether from stillbirth OR a molar pregnancy is devastating. If any of you ever need someone to talk to or ever have any questions I'm here to talk.

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    1. Keep us updated on you and your pregnancy. I am so sorry you have been through so much and hope you continue to have good news to share! (((hugs)))

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  8. hi- can someone give me an update on what they found out? i believe i am 4 weeks pregnant and the first time i had an ultrasound, the doctor said she believed it was a molar pregnancy.. i went in for blood work on Thursday and Saturday it had almost double (4000-7000).. and she still said it was a molar pregnancy.. this would be my first pregnancy ever and me and my husband has been TTC for 2 years now.. i just really hope the doctor was wrong..any thoughts?

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  9. After losing a pregnancy at 14 weeks, and after taking a couple months off of fertility treatments to let my body heal, my husband and I began IUI again in April. At the end of the month, right on schedule, I had a light period. I was bummed, but went back to my fertility specialists a few days later for baseline blood work and ultrasound so I could do another round of IUI and that's when the doctor found a mass in my uterus and thought it might be a fibroid tumor. He asked me to hold on while he went back to look at ultrasound pics from previous months and video from a hysteroscopy I had a month or two prior. He came back and asked if I was pregnant. I told him I'd been feeling pretty awful, but thought it had just been my period. He told me we'd wait to get bloodworm back in a few hours, but it was basically either a tumor or a baby. Later that day he called me and told me I was pregnant, but my hcg levels were unusually high and he was concerned it was a molar pregnancy. I was scheduled for an ultrasound at the hospital just hours later. Again, they couldn't tell me what was going on but said it absolutely didn't look like a healthy pregnancy- there was a mass and no gestational sack. The doc said he'd keep an eye on my but didn't have much hope for a successful pregnancy and worse, to prepare myself for a dnc. The next week when I went in for an ultrasound they saw a gestational sack, a week later a heartbeat and fetal pole, and that mass-- it was dried blood that has been slowly being reabsorbed by my body. At 7 weeks, the doctor said everything looks great. I just wanted to give hope to those that are going through this. If it's early in your pregnancy, give it time. I'm so happy I wasn't rushed into a dnc the way so many people are.

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    1. Lauren that is wonderful news! Could we share your story on the Misdiagnosed Miscarriage site? I think you'll give many women hope :)

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  10. At around 7 weeks the doctor saw something odd on the ultrasound and referred me to a high risk fetal medicine specialist. This meant I would have to wait a bit over 3 weeks to find out. The doctor thought I might have a partial molar pregnancy or that whatever he saw could resolve itself in a couple of weeks. I had the ultrasound done with much better equipment with the high risk fetal medicine doctors and turned out there was nothing to worry about and couldn't see anything bad. It's difficult for doctors to diagnose since most have never seen one and can only guess. I am so happy it wasn't a partial molar pregnancy!

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    1. Good news! So glad they found out that all was okay. Your doctor did the right thing. A molar pregnancy can be quite serious. Wishing you the best during your pregnancy!

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  11. I've hsd 3 miscarriages, 2 spontaneous and 1 missed miscarriage that ended in a d&c... this last one was full of complications although it only lasted 8 weeks. Doctors thought it was a partial molar pregnancy and pushed for a d&c. After we were told the pregnancy was not viable anymore,That there was no progress, No development we agreed to a d&c to check it wasn't a pmp. And it wasn't...Thank God!.

    So let me tell you how it all strated. I started spotting at 5 weeks but my insurance (KP) ob department wouldn't take me in because I wasn't 8 weeks yet. I e-mailed 2 ob doctors I had seen before. Nurses replied to my msgs. One said to reffer all my questions to my primary dr. The other have me obstructions on what to take for pain till my 8 week appt. I decided to pay out of pocket to go to another doctor outside of my i surance. She saw me had an ultrasound and saw what I didn't get to see with my 2 other pregnancies. I saw yhe sack. Dr put me on bed rest. Then I went out of town for the weekend (i was resting during that too) and I had heavy bleeding. I thought I had lost the baby but I didnt. I went back to the out of pocket dr snd there was now a sac and yolk. There was progress. Then I was advised to report my bleeding incident to my primary dr (at kp) so I did. He sent me for an ultrasound and blood work to check ny hCG levels. At this point I was 6 weels 6 days. Urgent care read my results. No heartbeat and hCG levels at 171k. Next day I had a case manager (rn) calling me on behalf of an OB had never seen or met. 2 daus later they jaf me repeat hCG levels a d came back at 199k. Next dau the case manager tells me the dr who I haven't met wants to see me and to come ready for a d&c becaused based on mu hCG levels the dr. Thinks it's a molar pregnancy. I researched like crazy that day. I called the other dr who advised against it. She said it didnt look like a molar. I was dumb ans still went to kp dr. She told me she was ready to send me for a d&c but that the ultrasound I had that day showed development. That the ults tech reported to see a 6 week fetal pole thst to her it didn'took like a fetal pole butthey were calling it that so she would call it that . She said with my luck with my regnancies she was sure I would wznt to give it more time so to give it a week but to come ready for a d&c the following week. She ended with a horrible pelvic exam that left me cramping. And for like the 10th time said to come ready for a d&c on the next appt. The following week I saw the out of pocket dr. She informed me there has been bo growth and that my pregnancy was no longer viable. The nexy day I hadan appt with my insurance dr. Theu told me the same thing and wanted me to havr a d&c right away. I refused theu didn't like it. Next day the nurse and dr called me harassing me about needing to have the d&c right away. They got me mad I called till I got through to someone who would listen to me. I got a srcond opinion within my insurance. Nicer more plesant and compassionate. This dr suggested a d&c as well just to rule out a partial molar. My husband and I agreed to it. And it came back it's not a pmp. Thank God because it means we can try again soon and i don't have to go through that tedious process. I advise you grt a 2nd or 3rd opinion. I still don'tike how they are handling my situation. Since they were goung based on hCG levels to call it a pmp, I asked for what could have caused the high hCG levels now that it was ruled out and tbe answer was that was just you. Sometimes its just the person. They just have high hCG levels. SMH... so ask question we have that right. I am so glad I was cleared. Now I'm dealing with feeling of anxiety but I guess that's another topic. Best of wishes for anyone dealing to all who come here looking gor answers like I did. May God bless you all and grant you your hearts desires.

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    1. I am so sorry you have had to go through so much. Thank you for sharing your story. Getting those second, third, or even fourth opinions are important. No matter the ending, women should feel comfortable with their doctors. (((hugs)))

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