How does the pregnant woman avoid the gestation period having the hydatidiform mole phenomenon
The hydatidiform mole is benign disease, it is a series of disease’s start, this series disease is called the pregnancy trophoderm cell disease (Gestational trophoblastic disease, GTD). Its characteristic is the trophoderm cell (trophoblast cell) unusual proliferation. The hydatidiform mole outward appearance, to become the string the water pocket, the size varies, shape by naked eye obviously similar grape’s outward appearance, because acquires fame. These are each one down (chorionic villi) the extreme dropsy create. Because these cells are come from the trophoderm the cell, will therefore secrete the human chorion gonadotrophic hormone (human chorionic gonadotropin, hCG). In the patient blood, hCG density unusual high, this is its characteristic. This series other three kind of diseases all are the malignant disease, respectively be attack hydatidiform mole (invasive hydatidiform mole), placenta position trophoderm cell tumor (placental-site trophoblastic tumor) and choriocarcinoma (choriocarcinoma). The hydatidiform mole divides by the pathology organization, may divide into the complete hydatidiform mole (complete mole) and the part hydatidiform mole (partial mole). The complete hydatidiform mole for double draught chromosome 46XX, minority is 46XY generally, but all chromosomes all come from the paternal line. Why will have this kind of phenomenon? Possibly is the sperm with does not have the egg which the chromosome or the chromosome do not move, after the fertilization, halfth the set of chromosome 23X duplication sperm becomes, or two sperms with do not have the egg fertilization which the chromosome or the chromosome do not move, but produces this kind of all chromosomes to come from the paternal line the phenomenon. The complete hydatidiform mole’s characteristic includes: (1) the down assumes the universality dropsy, increases. (2) outside down trophoderm cell proliferation. (3) in down blood vessel vanishing. (4) does not have the embryo and the embryo organization.
The part hydatidiform mole’s chromosome majority is three sets (triploid), is becomes as a result of a normal egg with two sperm unions, therefore the chromosome is 69XXX,69XXY or 69XYY. Its characteristic only then partial down dropsy, trophoderm cell partial proliferation, and has the embryo or the embryo organization. But coexists embryo common serious congenital deformity.
Compared with easy to have the hydatidiform mole factor to have two, is mother the age and the pregnancy history. In age aspect mother below 20 years old, as well as above 40 years old is pregnant, for the hydatidiform mole, is 21-35 year-old mother’s 5-9 times. But 40 year-old above mother compared to 20 year-old following mother, the risk is higher. Father’s age has not affected. In pregnancy history aspect, two above continuously natural abortion’s mother compared to normal mother, risky high 32 times, is also natural abortion’s mother is quite continuously easy to produce the hydatidiform mole. If compares by the country, the Asian country has the high formation rate. Says by the world average, every 1000 are pregnant mother, approximately has 0.5-2 hydatidiform mole. At present the study research, already determined four factors and the hydatidiform mole formation related:
1. The close menopause time occurs the pregnancy, easy to have the hydatidiform mole and the choriocarcinoma.
2. The Asian country has the high formation rate.
3. The patient and husband’s ABO the blood-group, concerns with the risk.
4. The complete hydatidiform mole has the choriocarcinoma most main factor.
The hydatidiform mole earliest clinical symptoms are the colporrhagia and the hypogastralgia, is often diagnosed in the pregnancy initial period for the omen miscarriage or not the complete miscarriage. Moreover some mothers will have disgusting, the vomit, before the eclampsia, sickness symptom. When pelvic cavity inspection, will discover that the womb will compare pregnancy Zhou Shuda. Because the hydatidiform mole trophoderm cell will still secrete hCG, the ovary received the highly concentrated hCG stimulation, will be tumescent, saccate, ovary’s oogonium membrane cell (theca cells) met the leuteinization. But this kind of ovarian cysts, after the patient accepts the treatment hCG drops, also vanishes naturally.
The supersonic wave inspection diagnoses the hydatidiform mole very good way. Because of the supersonic wave may other hydatidiform mole, the omen miscarriage and the ectopic or extrauterine pregnancy. Because the supersonic wave inspection is simple, moreover the present supersonic wave is very common, therefore many pregnant women when the being pregnant early time, the colporrhagia or do not even have the symptom accepts the supersonic wave inspection, the accident discovered that the hydatidiform mole has plenty of such people. The hydatidiform mole in the supersonic wave, may see many snow patterns the thing fills in the uterine cavity, looks like “the snowstorm” very much (snow storm). Moreover in the examination hydatidiform mole patient blood the hCG density may also take the diagnosis, in the hydatidiform mole patient blood’s hCG density compared to normal badly is pregnant when high, when twin pregnancy must be higher. Generally speaking, when in the blood serum hCG is bigger than 100,000miu/ml, might determine probably for the hydatidiform mole perhaps other malignant GTD.
As soon as after the hydatidiform mole diagnosis passes through the determination, should decide the treatment way, treats as soon as possible. But before treating, the chest X light, the electrocardiogram and the blood routine inspection need to do. The hydatidiform mole main treatment way has the following four kinds:
1. Vacuum attraction excochleation (suction curettage): This law is the most effective safest treatment way. The aspiration will deliver the pathology chemical examination, by determined that good or the malignancy, in the vein intravenous drip must join the uterus contraction medicinal preparation to help the uterus contraction. What but must pay attention, this kind of patient’s womb is very soft, when the survey womb size, the attraction, blows except, must be careful, otherwise easy to wear out the womb wall.
2. Womb excision method (hysterectomy): The age is big or does not regenerate the child the patient, may select this method. But the hydatidiform mole, the womb blood vessel meets the hyperemia, when surgery must pay attention to the massive hemorrhage. Hydatidiform mole after womb excision, has the possibility to produce GTD, therefore tracing is continually must.
3. Womb incision technique (hysterotomy): This law is cuts open the womb, eliminates the hydatidiform mole organization.
4. The medicine induces labor (induction)
The following two methods, easy to create the down cell’s shift, therefore little uses generally.
After usually production, after or miscarriage, 2-3 week hCG will drop to the normal value. But hydatidiform mole after treatment, then must 2-3 months be able to drop to the normal value. Complete hydatidiform mole after treatment, 80% will restore normally, 15% will turn the attack hydatidiform mole, 5% will develop the choriocarcinoma. The part hydatidiform mole only then 5% develop the malignant tumor. Therefore no matter what kind of hydatidiform mole after treatment, must trace continually for one year, by against malignization. And in tracing one year, cannot be pregnant once more, in order to avoid recurs.
Some women refer to the hydatidiform mole are the discolorations, actually the hydatidiform mole is the benign disease. Even if the unfortunate development is the malignant tumor, also smelts the extremely high malignant tumor, so long as can follow doctor’s instruction and the treatment, the hydatidiform mole as well as this series’s disease, and is insufficient extremely panic-stricken.
