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.
 

14 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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