Sunday, December 02, 2007

A cruel deception

Rosie Lewis believed she’d had a miscarriage. But she didn’t know a phantom pregnancy had continued to grow inside her

My seventh wedding anniversary had been idyllic. To celebrate, my husband had bought me a cashmere robe (it’s the wool anniversary), and we’d taken our two boys, Harry and Jonah (then four and two), for a picnic at the zoo. In the evening, a friend came to baby-sit, as we had a table booked at our favourite French restaurant.

Just as I was putting on my final slick of lipstick, however, our perfect day came to an abrupt end. What felt like an internal organ the size of a 10oz steak dropped out of my vagina into my silk knickers. Blood gushed down my legs until I was standing over a pool the size of a dinner plate. It then slowed to a trickle — like a tap that hasn’t been turned off properly. I was so shocked, all I could do was stand and stare in disbelief at the bright-red blood against the white of the bathroom floor tiles. I was terrified.

Luckily, the boys were downstairs on the sofa with their father. I could hear him reading We’re Going on a Bear Hunt. I called my friend and, with a hand towel stuffed between my legs, we cleaned up the blood and flushed the “mass” down the toilet. I couldn’t bear the thought of the boys being frightened by the mess. My friend kept saying, “I’ll deal with this, you’ve got to get to the hospital”, but I just couldn’t leave until the bathroom was spotless. That must have been part of the shock.

In A&E, I expelled another spongy mass, half the size of the first, and bled a lot more. So much for the gourmet feast I’d been dreaming about — they had me on nil by mouth.

Once the doctors got my notes, they pieced everything together. Two months previously, I had had a miscarriage. Ten weeks into that pregnancy, I’d had some brownish-red spotting; a scan had revealed a small blob with no heartbeat. I’d been given a surgical Evacuation of Retained Products of Conception (ERPC), under general anaesthetic, and sent home.

Ever since the miscarriage, I hadn’t felt quite right. I’d been overly tearful and sensitive — and this hadn’t been my first miscarriage, so I knew what they felt like. Several people had asked me when the baby was due, because my stomach was so bloated. I hadn’t had a period, but didn’t think that was too strange after a miscarriage. In fact, I remember saying to my husband that I still felt pregnant — although I knew I couldn’t be — because, after the miscarriage, my libido had vanished and we hadn’t made love since.

The night of our anniversary, I had a scan, blood tests and, eventually, another surgical evacuation. Some of my tissues, I was told, had been sent to a laboratory for examination.

A few days later, a gynaecologist told me that a liquid-filled mass of cells had been growing in my womb, and that what I’d thought was a miscarried pregnancy had, in fact, been a molar pregnancy, otherwise known as a hydatidiform mole. This arises when the trophoblast (the pregnancy cells from which the placenta develops) grows in a disorganised way, filling the womb at the expense of the embryo. In other words, instead of the baby growing within the placenta, the placenta alone grows as a series of cysts (like grapes). Nobody knows exactly what causes a molar pregnancy. All they know is that the pregnancy fails at the time of fertilisation. My first ERPC had not removed the whole mole, so it had continued to grow, tricking my body into thinking it was pregnant.

After the diagnosis, I was advised not to get pregnant or take the contraceptive pill for a few months, because any hormonal disruption can mask high levels of the pregnancy hormone hCG. This is important, because, if these are elevated, it can mean the mole is still growing. I was told that, in rare cases, these tumours can be cancerous and need treatment (usually chemotherapy).

I had to send two-weekly, then monthly, urine samples to the Gestational Trophoblastic Tumour Screening Unit at Charing Cross Hospital, in London, to check that my levels of hCG had gone back down to normal. As in the majority of cases, the hormone levels dropped fairly quickly, and I was monitored for only six months. If they had taken longer to drop, I would have been monitored for two years. I was also asked to send in urine samples after any future pregnancies, as occasionally dormant (and undetectable) molar tissue cells are triggered into activity by a new pregnancy.

Thankfully, after we were lucky enough to have our third baby boy, Luke, I dutifully sent off my samples and was relieved to receive a letter from the hospital stating that they were “satisfactory”.

The strangest thing about the whole experience was that, when I told my mother I’d had a molar pregnancy, she said: “Ooh, I had one of those.” I knew that she’d had a miscarriage before I was born, but we’d never really discussed the details. Because all of the mole growing in her was removed once it was realised she had miscarried, it didn’t continue to grow and cause a huge bleed, as mine did. In fact, my mother’s is a much more typical story of women who have a molar pregnancy.

Despite my rather more dramatic experience, my husband and I make a point of going to a fabulous restaurant each year to celebrate our anniversary — and to drink a quiet toast to the baby that never was.


— A hydatidiform mole is one of a rare group of conditions known as trophoblastic tumours. They are the result of what are called molar pregnancies, which occur in about 1 in 800 pregnancies in the UK.

— Occasionally, the mole tissue may grow and spread — this is an invasive mole.

— In fewer than 10% of cases, a complication occurs (known as choriocarcinoma) and the cells become cancerous. Chemotherapy is then required. It is possible to detect this complication, so a molar pregnancy is followed up for months or even years afterwards. The cure rate is almost 100%.

— A second molar pregnancy happens to just over 1% of women affected by a first.

— To find out more, contact The Miscarriage Association; 01924 200799, .


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