Whenever you suspect a molar pregnancy, you must send the woman to a health facility as soon as possible.
The other cause of early pregnancy bleeding is molar pregnancy, which you already learned about in Study Session 10. You may encounter this problem occasionally. It is characterised by an abnormal growth of a tumour formed from the future placenta during early pregnancy. The uterus fills with grape-like tissues and grows bigger than the size it will attain at full term of a normal pregnancy (Figure 20.4).
Can you recall the signs of a molar pregnancy?
No fetal heartbeat can be heard. No baby can be felt when you palpate the mother's abdomen. The woman has had nausea all through the pregnancy. She has spotting of blood and tissue like bunches of grapes coming from her vagina.
One of the feared complications in molar pregnancy is it may lead to severe bleeding which may result in the death of the mother. If the women presents with bleeding from the vagina, start an intravenous (IV) line and fluid infusion (as described in Study Session 22 and practised in your practical skills training) before making a referral. The fluid should run as fast as 60 drops per minute. The woman should be escorted to the health facility by healthy adults who can potentially be blood donors.