The bladder mole is rare: Only 0.1 percent of all pregnancies involve this maldevelopment. Those affected often do not even notice it, because all the signs of pregnancy appear. It is often mistaken for a wind egg. But there are a few signs that are typical of a bladder mole.

Bladder Mole: What Is It?

The bladder mole is a rare abnormal development of pregnancy: it affects only about 0.1 percent of all pregnancies. In this case, the tissue that develops into the placenta simply keeps growing. In the process, the growths can grow into the uterine muscles and also spread beyond the uterus. When this happens, it is called an invasive or destructive bladder mole. The cells then travel with the blood to the lungs or liver, even to the brain.

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Even if the description sounds malignant – it is not and therefore curable. However, in very rare cases, a bladder mole can later develop into cancer. Therefore, the only possible treatment is surgical removal of the growths.

How Does A Bladder Mole Develop?

The reason for its development is fertilization, which takes place, but something went wrong. As a result, the embryo does not develop properly. Mola hydatidosa, as it is called in Latin, thus inevitably leads to maldevelopment of the unborn child.

Scientifically, this disease is classified as a trophoblastic disease. Trophoblast is another name for the cells that will form the placenta during pregnancy. On the other hand, the cells from which the embryo grows are called embryoblast. The father and the mother normally inherit one complete set of chromosomes each. This consists of 23 chromosomes. If one set is missing or duplicated, then a bubble mole occurs.

Because a complete set of chromosomes normally consists of 23 chromosomes, a fertilized egg cell has 46 chromosomes: 23 from each parent. In the case of a bladder mole, things are different. Here, the correct chromosomes do not meet, which is why the cells grow but form abnormalities. Depending on which set of chromosomes is there or missing, we speak of complete or partial bubble mole.

These Types Of Bubble Mole Exist

Complete Bladder Mole

In this case, all chromosomes of the mother are missing in the egg cell. Instead, the set of the father is duplicated. This means that there is no embryoblast and therefore no embryo. Not even the amniotic cavity is formed, as would be the case with a wind egg. On the other hand, the trophoblast will form many vesicles in the uterus, which will look like snow flurries on ultrasound. These small bubbles also give it the nickname grape mole.

Partial Bubble Mole, Also Called Partial Mole

In this case, two chromosome sets of the father are added to the chromosome set of the mother, i.e. one too many. In total, we do not have the normal 46 chromosomes (2 times 23), but 69 (3 times 23). This is caused, for example, by two sperm cells fertilizing one egg cell. Here embryo and placenta develop, the embryo could even be carried to term. But it will never develop normally! Rather, it will always have a genetic defect and is therefore not viable.

Bladder Mole And Twin: What Is The Difference?

A twin pregnancy can also arise from one egg cell, in which case it is monozygotic, which means that the egg cell divides into two identical embryonic units. However, twins can be viable, while a bladder mole will never be viable, even if the embryo develops with yolk sac. A study in London found that among 77 twin pregnancies, there was only one bladder mole.

What Is The Likelihood Of A Bladder Mole?

Fortunately, this complication does not occur often in pregnancy. A diaper egg, for example, is much more common! Out of 1000 normal pregnancies, only one develops into a bladder mole. However, there are risk groups, although it is not clear for all of them why they are included. Asian women, for example, have an increased risk of bladder mole. Younger women under 20 and older women over 40 are also more likely to experience bladder mole. Those who have had multiple miscarriages are also at increased risk.

Bladder Mole: These Are The Signs!

Initially, the signs are similar to those of a normal pregnancy. Therefore, not every bladder mole is noticed immediately. Later, however, bleeding occurs, which can also occur normally, but it is better to clarify.

Bleeding during pregnancy? Here you can read what else it can have to do with it!

What is the specifics of bleeding due to a bladder mole: They are often differently colored, for example very dark or extremely light. Sometimes even grape-like tissue comes off with it. Bleeding of this kind is possible at any time and can reach any strength, from weak to strong. Therefore, always have any bleeding clarified by a doctor or midwife!

Other signs of bladder mole are so uncommon, however, that those affected become suspicious at this point at the latest. They suffer from dizziness and extremely strong nausea. In addition, the abdomen swells more rapidly than would be the case in a normal pregnancy. This is of course due to the growths and the fact that the uterus expands rapidly as a result.

Bladder Mole And HCG Value

A very high hCG value also indicates a possible bladder mole. The reason: If the placenta grows so quickly, the hCG value also shoots up. This is the so-called pregnancy hormone human chorionic gonadotropin, abbreviated hCG. It is also responsible for the abnormal nausea.

You don’t know the hCG value yet? Never mind: Learn more about it here!

Danger Of Confusion: Wind Egg And Bladder Mole

Uninformed people like to confuse the bladder mole with the so-called wind egg. If the pregnancy is examined by ultrasound, the wind egg shows a very typical picture, which differs greatly from that of the bladder mole. The wind egg is basically an empty amniotic cavity without a yolk sac, since the embryo simply does not develop here from a very early stage. Some people also refer to a wind egg as the origin of the bladder mole. But this is not correct, because both look completely different.

When Is The Bladder Mole Clearly Detected:

Therefore, if you have an ultrasound done very early, you have every chance of discovering the complete bladder mole early: For example, in a bladder mole, the heartbeat of the fetus is missing, which is clearly visible in a normal pregnancy. Rather, all that can be seen is the aforementioned snow flurry. In addition, the blood test reveals that the hCG level is unusually high for this early stage of pregnancy.

A partial mole is not easily detected: Ultrasound often reveals no evidence of it. However, the unusually low hCG value makes the gynecologist aware of what it could be. In suspected cases, the doctor will then palpate a greatly enlarged and very soft uterus, which provides a further clue.

Sometimes something like this only comes to light as a result of a premature miscarriage. If a pathologist then examines the tissue, the partial mole can be diagnosed with certainty.

Bladder Mole: What Is The Therapy?

Unfortunately, there is not much that can be done for a bladder mole, regardless of its form. Treatment always consists of suction, which frees the uterus from the growths. This takes place under general anesthesia at the gynecologist’s office. During this procedure, the cervix is carefully dilated to gain better access. The gynecologist then uses a suction curette to remove the growths.

Because follow-up care takes a lot of time, an affected woman should not become pregnant for a while. If she becomes pregnant again too early, it is difficult to distinguish between what belongs to the new pregnancy and what is still growing. That is why follow-up care does not only include regular blood tests.

Follow-up Care For A Bladder Mole

Over the course of the next six months, blood will be tested again and often. The problem is that some of the tissue may have remained without the gynecologist noticing. To be on the safe side, the hCG level must therefore be monitored continuously. If it normalizes quickly, everything has been completely removed. If not, the procedure must be repeated. This is because even smaller pieces of tissue can grow again and spread throughout the body. This can still happen months after the procedure.

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Invasive Bladder Mole As A Complication

The pregnancy-related condition can become a permanent one, which is the invasive bladder mole mentioned earlier. The risk of this depends on the type of bladder mole. If it was a partial bladder mole, this occurs in no more than one percent of those affected. Women with complete grape mole are more often affected: Here the percentage can be up to 15 percent.

Those who are affected notice this primarily by persistent bleeding after aspiration. This should not actually happen and indicates further proliferating tissue. Treatment then resorts to chemotherapy. This kills the growths with absolute certainty, and the cure rate is almost 100 percent. The prerequisite is that rapid action is taken once the invasive type has been identified.

Further Complications Of Bladder Mole

As rare as the bladder mole is, this following complication is even rarer. Then it comes to the development of cancer.

This is called chorionic carcinoma as a result of persistent pregnancy-related trophoblastic disease. The prerequisite is therefore already a complication, which in turn is a complication, namely of the pregnancy. You can imagine that this is very rare: it is an exception, which can occur in one out of 30,000 pregnancies. Here again chemotherapy is used.

Those who have been able to fight the cancer must have their hCG levels checked throughout their lives.

What Is The Recurrence Risk Of A Bladder Mole?

It is extremely unlikely that such a rare bladder mole will recur several times. The risk is virtually impossible to measure, that is how low it is. This rare genetic complication therefore usually occurs only once in those affected. After that, a new pregnancy is possible without any problems.

When Is A New Pregnancy Possible After Bladder Mole?

Nevertheless, a break of twelve months is necessary after the hCG value has reached normal levels. Only then can you try to become pregnant again. After all, one of the characteristics of a bladder mole is the increased hCG value – just as with a pregnancy! Contraception is therefore the best thing to do in order to meet this deadline. But avoid IUDs during this time!

Conclusion Bladder Mole: Rare And Easy To Treat

Bladder mole is a complication of pregnancy. Its result a non-viable embryo or certain growths that arise from the placenta. In this case, all the signs of a normal pregnancy are present, similar to the wind egg, with which the bladder mole is often confused. However, in the case of bladder mole, these signs appear in an exaggerated form: An unusual hCG course indicates this, as does extremely severe nausea and an abdomen that swells beyond measure. If frequent and heavy bleeding occurs, this can also be a sign. In this case, the expectant mother should see a doctor immediately!

If the pregnancy is then examined by ultrasound and the uterus is palpated, clear signs of a bladder mole can be found. Once the diagnosis has been established, a suction procedure takes place. However, removal of the growth does not completely end the problem. This is because the tissue changes can recur for months after the suction. Therefore, it is important for women who want to have children to wait a year before trying again. Fortunately, however, bladder mole is very rare. Women with bladder mole experience can therefore normally be safe from a recurrence.