When Michelle McGrath went for her first pregnancy ultrasound at 10 weeks, she was devastated to be told there was no heartbeat. But she wasn't surprised.
Overwhelmed by exhaustion “from day one”, she says she’d always had a feeling her pregnancy wasn’t normal.
“I actually remember thinking at one point, ‘Am I getting chronic fatigue?’” says Michelle. “In hindsight I think it was my body trying to expel something that wasn’t right.”
Though she suspected her pregnancy wasn’t normal, she wasn’t expecting what the doctors said next: she was most likely experiencing a partial molar pregnancy.
The then-35-year-old hadn’t heard of the condition. “I was just like, ‘What is that?” she says.
The doctors explained that molar pregnancy occurs when not only does the foetus not develop properly, but the placenta proliferates out of control, forming a tumour of unwanted placental cells.
Dr Michael Van Der Griend, private obstetrician and gynaecologist at North Shore Private Hospital, says molar pregnancies are rare, occurring at a rate of about one in every 1000 pregnancies.
While rare, he points out they’re more likely to occur in women aged over 40, Asian women, and in women who have had a previous molar pregnancy (though he reassures the risk of recurrence is only around 1-2 per cent). Michelle, however, had none of these risk factors.
While molar pregnancies can be classed as partial or complete, Michelle was told hers was the former – which is the “less worrying” type.
Dr Van Der Griend says that in partial molar pregnancies “you can sometimes see a foetus, but it will not be viable”. In complete molar pregnancies, there is no foetus at all. “So there’s no baby there, it’s just placental tissue,” he explains.
Complete molar pregnancies are more worrying because they have greater potential to “persist” and become cancer-like, spreading to other areas of the body, according to Dr Van Der Griend.
After being told the likely diagnosis, Michelle was informed she needed surgery (a curette) to remove the unwanted cells, as well as a biopsy to further examine the tissue.
“When I went back [for the results] they said, ‘It was worse than we thought, it was a complete molar pregnancy’,” she says.
Michelle was shocked to discover she needed urgent investigations to make sure the abnormal cells hadn’t spread or become cancerous.
“I was sent immediately for a chest x-ray because they said, ‘Look, we need to check there are [no cancer cells] in your lungs, in case you need to have chemotherapy.’”
While Dr Van Der Griend understands the reasoning behind doing further tests such as x-rays, he says the chances of a molar pregnancy becoming metastatic cancer are very slim.
In fact, he says that a curette is “usually curative” and that most women don’t need further treatment afterwards.
“So if you do a curette and get out [all the abnormal tissue], the likelihood of [cancer spreading] is low,” he explains.
Instead, most women simply require monitoring of their blood levels of the hormone hCG through regular blood tests. These levels should continue to drop after the molar pregnancy is removed.
Thankfully, Michelle was given the all-clear from her chest x-ray. She then went on to have monthly blood tests for a year at a cancer clinic, all of which came back with reassuring results.
While it was a difficult time in her life, Michelle remains philosophical about the whole experience.
“I thought, ‘Well, these things happen,’” she says. “I put more of a spiritual perspective on it.”
Michelle is now 43 and no longer with her husband. She has not had any further pregnancies – not because she was scared of having a second molar pregnancy, but rather because she’s chosen not to.
And while she says at this stage she “assumes” she won’t have children, she is more than happy with her life. “Fortunately my life is very full … [Having children] isn’t the be all and end all for everybody.”