The impact of molar pregnancy on psychological symptomatology, sexual function, and quality of life

Background. Molar pregnancy is an unusual complication of pregnancy whereby abnormal placental tissue proliferates in the absence of a fetus. There is usually a protracted follow-up period where pregnancy is contra-indicated. Whilst the medical outcomes of the disease have been well explored, limited data have evaluated the impact on psychological symptomatology, sexual function, and quality of life. Methods. Institutional ethics approval and individual consent were obtained. All women listed on the hospital molar pregnancy register receiving active follow-up (n = 102) and a random sample of women who had been registered in the previous 30 years (n = 56) were sent a postal survey outlining the purpose of the study and an invitation to participate. Questionnaires included the Hospital Anxiety and Depression Scale (HADS), Satisfaction with Life Scale (SWLS), and Sexual History Form 12 (SHF-12). Results. The response rate was 54%. The key findings were that 60%, 55%, and 18% of women scored >= 10 on the total HADS, 8 on HADS-A, and > 8 on HADS-D, respectively. The presence of children played a protective role and was associated with significantly better psychological function and quality of life. SWLS were in the lower end I of ranges reported for community controls (mean of 23.9). Chemotherapy had an adverse impact on quality of life ratings (SWLS for chemotherapy yes = 21.7, no = 25). Sexual dysfunction was similar to community samples and was independent of age, time since diagnosis, chemotherapy requirement, and presence of children. Qualitative results complemented the quantitative data with similar emotional themes identified as well as issues related to the medical condition, care, and support networks. Conclusion. Women with a molar pregnancy may benefit from a multidisciplinary approach to management that addresses their psychological and sexual needs in addition to medical aspects of care. (c) 2005 Elsevier Inc. All rights reserved.