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Surgery for molar pregnancy

Men and women discussing gestational trophoblastic tumours

This page tells you about surgery to treat a molar pregnancy. There is information below about

 

A quick guide to what's on this page

Surgery for molar pregnancy

You need surgery to confirm the diagnosis of a molar pregnancy. After surgery, doctors called pathologists examine the tissue from your womb under a microscope.

Dilatation and curettage (D and C)

Most women with a molar pregnancy will only need this simple operation. You have the surgery while you are under general anaesthetic in hospital. The surgeon opens up (dilates) the entrance to the womb and uses gentle suction to remove as much of the tumour as possible. They then use a small instrument called a curette to scrape the lining of the womb and clear away any remaining molar tissue. So this operation is sometimes known as a scrape.

You will stay in hospital for at least a few hours after a D and C. Your doctor may want you to stay overnight to give you time to recover after the general anaesthetic.

Hysterectomy

An operation to remove your womb is called a hysterectomy. This is very rarely used to treat a molar pregnancy. But your doctor might consider this operation if the molar pregnancy is causing a lot of bleeding from your womb They may also suggest it if you already have a condition of the womb (for example fibroids), and you don’t want to have any more children.

 

CR PDF Icon You can view and print the quick guides for all the pages in the treating molar pregnancy section.

 

 

Why you have surgery

A molar pregnancy occurs when the fertilisation of the egg by the sperm goes wrong and leads to the growth of abnormal cells or clusters of water filled sacs inside the womb. It is a type of gestational trophoblastic tumour (GTT)

You will need to have surgery to confirm the diagnosis of a molar pregnancy. After surgery, doctors called pathologists examine the tissue from your womb under a microscope.

You usually only need minor surgery to remove the molar pregnancy, or the tissue that’s left in your womb after a miscarriage. This is usually an operation called a D and C. Apart from follow up tests this is usually all the treatment you will need. A hysterectomy (removal of the womb) is sometimes needed but this is very rare. There is information about these operations below.

 

Dilatation and curettage (D and C)

Most women with a molar pregnancy will only need this simple operation. You have the operation under general anaesthetic in hospital. Once you are asleep, the surgeon opens up (dilates) the entrance to the womb (cervix) and uses gentle suction to remove as much of the tumour as possible.

The doctor then uses a small instrument called a curette to scrape the lining of the womb and clear away any remaining molar tissue. So this operation is sometimes known as a scrape. For a partial molar pregnancy, your doctors may give you a drug to make your womb contract and help to push out the abnormal tissue.

You will stay in hospital for at least a few hours after a D and C. Your doctor may want you to stay overnight to give you time to recover after the general anaesthetic.

 

Removing your womb (hysterectomy)

An operation to remove your womb is called a hysterectomy. This is very rarely used to treat a molar pregnancy. But your doctor might consider this operation if

  • The molar pregnancy is causing a lot of bleeding from your womb
  • You already have a condition of the womb, such as fibroids
  • You don’t want to have any more children

A hysterectomy is quite a big operation. There is detailed information about having a hysterectomy in the section about persistent trophoblastic disease and choriocarcinoma.

 

Tests after your surgery

For most women, the surgery removes most of the molar tissue and usually the remaining cells die off on their own. So no more treatment is needed. But sometimes the few cells remaining in the womb, or elsewhere in the body, carry on growing after the surgery. So you will need follow up tests to make sure you have no signs of remaining molar tissue after your surgery.

Follow up means keeping a very close eye on the levels of a hormone called hCG in your blood and urine. If the levels stay high or they go up, you may need to have a course of chemotherapy. About 10 to 15 out of every 100 women (10 to 15%) who have a complete molar pregnancy will need treatment with chemotherapy as well as their D and C. About 1 out of every 100 women (1%) with a partial molar pregnancy will need chemotherapy. 

Very rarely, after a hysterectomy for a molar pregnancy, there can be molar tissue elsewhere in the body that can continue to grow. If this happens you will need to have chemotherapy.

There is information about measuring your hCG levels on the follow up after molar pregnancy page in this section.

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Updated: 1 May 2014