Once a molar pregnancy is confirmed the first step is to evacuate the cells from the uterus. This is normally done by a small surgical procedure called a Dilatation and Curettage (D & C) but occasionally, particularly with a partial molar pregnancy, this is done with the use of tablets that make the uterus contract and expel the cells. The tissue removed at the time of the evacuation has a characteristic appearance, particularly in a complete mole and is often described as looking like a bunch of grapes.
Figure 4. Complete Molar Tissue Removed by Operation.
After the initial evacuation all women with a molar pregnancy should be registered in a follow-up programme that tracks what is happening to any cells that remain in the uterus and picks out those that need further treatment. In the UK all women who have a molar pregnancy are enrolled into a national follow-up programme based on repeated hCG measurements.
This allows the medical team to monitor the women in order to identify those whom the problem is resolving on its own and to intervene where monitoring indicates the cells are growing.