I was in for a shock yesterday when I got the news that there is tissue (possibly growing) in my uterus and producing hCG, but it’s not a baby. My obstetrician gave me a fair amount of information, both on my condition/diagnoses as well as on the procedure (d&c) I have to have done tomorrow.
Here’s what I found out about molar pregnancies from her:
Sometimes, a pregnancy that ends in miscarriage leaves behind some placental tissue in the uterus and, for unknown reasons, the cells continue to multiply even though there is no fetus. Other times, some fetal tissue remains as well but it is not viable. If the hCG shows a continual (even gradual) decline, it is probably not a molar. If, however, the numbers rise (even after initially dropping, as was the case with me), then a molar is possible, though not a guarantee.
A molar can also be caused by abnormal cell growth that never even contained a fetus. I know little about this kind because it is suspected that I did have a miscarriage.
There are a few options in regards to treatment of a molar pregnancy. The first, we already did, and that’s to give it time to hopefully pass on its own. Monitoring hCG levels (seeing them decline) and blood (and tissue) loss are good indicators of it passing. The second option is taking a medication to force bleeding in hopes that it will pass. My doctor, midwife and I do not think this is worth trying because I already bled SOOOO much that if it didn’t pass then, why would it pass now just through blood flow? The third option is having a d&c so they can remove all of it; this also allows my doctor to send it pathology to have it tested for abnormal (cancerous) cells. If there is growth following the d&c (which does sometimes happen and it’s called a recurrent molar), they have to be more aggressive; sometimes they can use a chemotherapy drug to kill the cells and in severe cases, a hysterectomy may be necessary. But the recovery rate after treatment is near 100% after a molar and most cases respond well to “just” having a d&c.
Starting next week, I will need to have a weekly hCG blood test until the numbers get back down to zero. Then, continue to have weekly tests to make sure the number stays at zero. So, basically for the next six to eight weeks I will have to get stabbed every seven days. :( Did I mention I have a phobia of needles? :'(
Now about having the d&c:
- I can’t have any food or drink (even water!) from midnight tonight until after the procedure tomorrow. My pre-op is at 11:30 and the surgery will start no later than 1:30. I actually just called and spoke with my doctor’s medical secretary because I was extremely nervous about fasting. Baby Elizabeth nurses a few times at night and also in the morning – How can I not have anything until after 2pm?! I’ll be sick/faint for sure! Well, she made me feel much better after telling me that they will start fluids in the IV as soon as get back there for pre-op so at least I won’t be dehydrated.
- I will be given a drug through the IV to knock me out for the procedure. This doesn’t exactly make me happy but it’s far better than being awake and thinking about what’s happening! I have had an endoscopy before so I know how my body reacts to that drug and I’m not worried about it. :)
- I will need to nurse Elizabeth right before the d&c and then “pump and dump” for the first feed afterward. The knockout drug (lol) won’t hurt her but it can have the effect of sedation on her so it’s best to skip that first feed. I’ve already pumped this morning and I will pump more today so Maggie and Stephen can still give her milk as I recover.
- I will have cramping and period-like bleeding afterward. Joy. :P
And I guess that’s it. Please, please pray one more time for me tomorrow. For my doctor’s steady hand and for my peace (as I am quite nervous). Thank you, ladies. ♥
A note about molar pregnancies and hCG levels:
Just because a woman’s hCG blood work shows high numbers doesn’t mean she will have symptoms or “feel” pregnant. My numbers began dropping two weeks ago and the pregnancy symptoms I’d had went away entirely during that time. When I found out that they were soaring again (19,000+), I was completely stunned because I’d had no symptoms and I was, in fact, feeling MUCH better both physically and emotionally. It was explained to me that hCG isn’t the only thing at play when it comes to pregnancy symptoms; progesterone, among other things make a big difference on how the woman feels. – Just thought that was interesting!
*Update: Click here to see how the D&C went.*
*Update: Test Results (how it all ended)*