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Bladder in the uterus. Bubble drift or chorionadenoma is a rare pathology of pregnancy. Stages of gestational trophoblastic tumors

Bubble drift - This is a rare pathology of pregnancy associated with the defective function of fertilization of the egg, incompatible with the development of pregnancy and the birth of a live fetus.

The result of the pathological process with cystic drift is the formation of an unusual tissue in the uterus instead of the normal placenta, consisting of aciniform clusters of vesicles filled with liquid. Chorionic villi are the source of such transformation. If the abnormal growth fills the entire uterine cavity, the cystic mole is classified as complete (classic). Partial cystic drift is localized only in a certain area of ​​the fetal membrane.

Sometimes there is another name for the cystic drift - chorionadenoma.

There is reliable data on the possible malignant transformation of any form of cystic drift. The malignant, and most severe, form of the disease is called a destructive cystic drift.

To understand the pathogenesis of pathology, it is necessary to recall the events following fertilization. Recall that two sex cells - an egg and a sperm - merge into one. Moreover, each of the "parental" cells endows the future embryo with chromosomes - female (X) and male (Y), 23 chromosomes from each. Of the 46 chromosomes belonging to the parents, the fertilized egg inherits only 23, and the male / female ratio determines the gender of the fetus.

A few hours after fertilization, the egg begins to divide, turning into a multicellular structure, which gradually moves towards the uterine cavity along the fallopian tube. After five days, the beginning of a new life reaches the uterus and is implanted (implanted) into its mucous layer.

Since the embryo has to constantly develop and grow, its outer shell must be firmly fixed at the implantation site. For this purpose, the outer embryonic membrane (chorion) at the point of attachment of the embryo to the uterine wall (the future placental site) forms peculiar outgrowths - branched villi, which, like the roots of a tree, sink deeply into the mucous membrane and connect to the blood vessels of the uterus, subsequently these villi will become a source the formation of the placenta. The remaining cells of the outer shell of the embryo are transformed into the umbilical cord and fetal membranes.

With cystic drift, the villi surrounding the fertilized egg do not form the placenta, but are reborn into a completely nonviable structure - an unusual, bubble-like tissue. The stroma around the villi swells, they grow with the formation of bubble-like extensions (cysts). When combined, these extensions become like bunches of grapes. Each cyst is filled with an iridescent yellowish liquid that secretes hCG chorionic gonadotropin (pregnancy hormone), so the hCG numbers for cystic drift have an important diagnostic meaning.

The embryo, which requires oxygen and nutrition for development, is normal pregnancy gets what it needs from the placenta, and in the case of a cystic drift, there is simply no such source, therefore, inevitable degradation and death of germ cells occurs.

Reborn tissue is not limited to where it belongs primary education, it begins to grow, and the affected area increases. This behavior of the tissues of the cystic drift makes it possible to compare it with a tumor.

The causes of cystic drift remain unclear, but reliable studies have established a connection between the development of pathology and the process of fertilization, when during the fusion of germ cells, the loss of maternal chromosomes and duplication of male chromosomes occur.

The clinical symptoms of cystic drift are ambiguous and depend on the behavior of the expanding chorion and the gestational age. More often, uterine pains, bloody leucorrhoea and a discrepancy in the size of the pregnant uterus are noted due date... Motor activity (movement) of the fetus, of course, is not observed.

The presence of a cystic drift is well visualized during an ultrasound scan, since the modified tissue has characteristic signs... No signs of the presence of an embryo in the uterine cavity are detected during scanning. The final diagnosis is carried out after the evacuation of the cystic drift and the study of the resulting tissues in the histological laboratory.

Unfortunately, in the treatment of cystic drift, the preservation of pregnancy is not provided, because the nonviability of the fetus in conditions of complete isolation from the elements necessary for development is beyond doubt.

Removal of the cystic mole is the only treatment. The unpredictable behavior of the growing unusual tissue requires its complete elimination, therefore, exclusively surgical techniques are used. Uniqueness this ailment lies in the fact that with its aggressiveness, the process can be completely eliminated if it is detected correctly and in a timely manner, without any consequences.

Pregnancy after a cystic drift is possible, but it is necessary to first be examined in order to prevent a repetition of the sad scenario. A clear pattern of recurrences of cystic drift has not been established, so the subsequent one can proceed and end properly.

The incidence of gallbladder drift is very small (less than 1%), but sometimes it appears in the conclusions of ultrasound diagnostics specialists, which is very frightening for patients. Meanwhile, not a single conclusion of a functionalist is a diagnosis, because for a correct diagnosis it is necessary to carry out several measures that will unequivocally indicate a certain pathology. Sometimes a cystic mole (especially a partial one) is simulated by other, less dangerous, pathologies that look very similar on the monitor, and the specialist writes an alleged, and not a final diagnosis of a cystic mole, which, fortunately, is often not confirmed.

What is a bubble skid

Vesiculate motility is the result of chromosomal abnormalities. It belongs to a special group of pathologies, united by the term "trophoblastic disease", which includes several conditions associated with abnormalities of the trophoblast (the outermost shell of the embryo).

Trophoblastic diseases are always either tumors or conditions close to them in structure and behavior, which in the end, in most cases, provoke a tumor process. They are unique and very rare, as they have a unique path of development - they appear from the products of conception, that is, they are diagnosed only in pregnant women.

As a result of physiological fertilization, the egg has 46 chromosomes - 23 female and 23 male. Bubble drift can develop along full version, when a fertilized egg is completely devoid of maternal, female, genes, and instead of them there are duplicated genes of the father, male in the amount of 46. It can also be caused by an egg without a nucleus fertilized simultaneously by two spermatozoa. Since the chromosomes of any cell are located in its nucleus, a nuclear-free egg does not contain them, and a double set of male chromosomes is provided by two spermatozoa.

Full bladder skid does not imply the development of the embryo, only a significant proliferation of villi occurs.

Partial hydatidiform mole is formed in a different way: the egg has the necessary nucleus with female chromosomes (there are 23 of them), but the double set of male chromosomes (46) is present in the sperm fertilizing it. As a result, 96 (46 + 23) chromosomes are present in the egg, and the fetus, nevertheless, begins to develop, but has multiple malformations due to the large number of additional chromosomes, so it is also not viable.

The tissues of the cystic drift behave like a malignant tumor - they not only grow significantly, grow through the uterine wall, but can also "spread" (metastasize) from the uterine cavity into the lungs. The degenerated trophoblast secretes chorionic gonadotropin, and since the tissue increases its volume excessively, the concentration of the hormone becomes excessive.

There are hypotheses about the influence of infectious processes on the regeneration of chorionic villi, and viral infections are also called especially dangerous in this regard.

One cannot reject the arguments of another popular theory of the origin of cystic drift, which links incorrect fertilization with hormonal dysfunction. As you know, for full development the egg cell needs enough estrogens, they provide the processes of folliculogenesis and subsequent ovulation. In conditions of estrogen deficiency, according to some experts, the egg cell can grow defective.

In re-pregnant women, as well as women who have undergone abortions, the chance of developing a hydatidiform mole increases threefold.

Symptoms and signs of gallbladder drift

Bubble drift is classified as complete or partial. A more rare invasive (destructive) form is distinguished separately.

The main criterion is the degree of degeneration of the chorionic villi: if the zone of their pathological transformation covers the entire chorion, the drift is considered complete, and if the chorion is not completely modified, it is partial. Regardless of the shape of the cystic drift, the fetus dies, and pathological process continues. The altered structures of the chorion grow quickly enough, so the uterus also becomes larger. It is the discrepancy between its size and the expected gestational age that suggests the dysfunctional development of pregnancy.

The timing of the formation of cystic drift is very variable: early cystic drift can be detected as early as the 9th week of pregnancy, and sometimes it is detected only by the 34th week.

The clinical picture of cystic drift is the more pronounced, the larger its area, therefore, with different forms oh she, although she has similar symptoms is somewhat different.

1. Partial hydatidiform mole - symptoms on early dates.

Partial cystic drifts, as already mentioned, do not affect the entire chorion. In the chromosome set with this form, there are both male (Y) and female (X) chromosomes, but their number and ratio do not correspond to the norm: for a single female chromosome accounts for twice the number of men. The hypertrophied tissue of the expanding chorion contains fragments of an unchanged embryo and placenta, chorionic villi in a state of pronounced edema.

At the initial stages, cystic drift mimics the symptoms of pregnancy, so it is difficult to diagnose it without additional examination.

Since the cystic drift does not cover the entire uterine cavity, the growth of the modified tissue occurs more slowly, the uterus remains normal for the gestational age or is slightly smaller. Therefore, at the beginning of the development of pathology, its symptoms may not be obvious, however, suspicious changes can be detected during an ultrasound scan.

Incomplete cystic drift does not exclude the development of pregnancy, since the pathological process starts after the third month of gestation and affects only part of the placenta. The fetus can die if the placenta is affected by more than a third.

2. Complete cystic drift - symptoms in the early stages.

It is diagnosed at the 11th - 25th week of gestation. All available chromomsomes are exclusively male. Signs of development of the embryo and embryo are completely absent, the uterus is filled with modified edematous villi and vesicles. With this form, the vesicular drift grows rapidly, so the uterus becomes large in the early stages.

3. A destructive form of cystic drift. It is even rarer than its other two forms. It is characterized by aggressive germination of villi to the entire depth of the uterine wall, followed by destruction of the surrounding myometrium tissues. Differs in pronounced internal bleeding.

Invasive cystic drift is essentially similar to a tumor process. The features of invasive cystic drift are:

- the tumor is usually local, with invasive (inward) growth;

- infrequently (20-40%) metastases to the nearby vagina and vulva, less often metastases are "sent" to the lungs;

- much more often than other forms of drift, it is transformed into a malignant structure - chorionic carcinoma;

- despite the aggressive course and the likelihood of malignant transformation, it responds very well to therapy and is 100% cured.

The size of the uterus, which does not coincide with the period, with cystic drift does not allow one to suspect this particular pathology without additional symptoms... It is especially difficult to determine on this basis early cystic drift in a partial form. Several other symptoms indicate the presence of chorionadenoma:

- Bleeding. It has a specific feature - the presence of typical drift bubbles in the bloody discharge.

When the regenerated chorionic villi grow, the excess tissue with bubbles is gradually separated from the uterine wall and "falls" into the uterine cavity, and from there it is evacuated outward along with the blood.

Blood loss provokes typical signs of anemia and worsens the well-being of the pregnant woman.

- Toxicosis. Depending on the period, they have a clinic of early toxicosis (nausea, vomiting, weakness, and so on) or gestosis (s).

- Lack of fetal signs. The fetus, against the background of a cystic drift (if it begins to form at all), dies very early, therefore all studies conducted indicate its absence. Pregnant women note that they do not feel how the fetus is moving.

Diagnostics of the cystic drift

The clinical presentation of cystic drift is not always obvious and can simulate other pathologies. Symptoms of cystic drift, namely an asymmetric increase in the uterus, must be differentiated from those with polyhydramnios and pregnancy against the background of fibroids. Any bleeding that occurs may indicate a spontaneous miscarriage.

The most reliable sign is the appearance of typical vesicles in the vaginal discharge, as a rule, their appearance heralds the "expulsion" of the cystic drift.

External examination does not allow you to feel parts of the fetus and listen to its heart. Vaginal examination helps to palpate areas of softening of the uterus, and also to establish that its size does not correspond to the gestational period.

An ultrasound scan shows a pattern that is rather typical for a cystic drift:

- an increase in the uterus, not comparable with the gestational age;

- the absence of the ovum in the early and the fetus in the later stages, with a partial form of drift, the preserved parts of the fetus can be visualized;

- the presence of a homogeneous fine-grained tissue (symptom of a "snow storm"), filling the uterine cavity;

- in every second pregnant woman, and against the background of hormonal dysfunction with cystic drift, luteal cysts are recorded in the ovaries of large (more than 8 cm) sizes, and in both ovaries symmetrically.

With an increase in the duration of pregnancy, the ultrasound picture of the cystic drift becomes more and more obvious.

Since cystic motility causes an excess build-up of the pregnancy hormone, laboratory determination its concentration is important diagnostic value... The concentration of hCG with cystic drift does not change in the same way as with normal pregnancy: it exceeds 100,000 mIU / ml and does not decrease after one week.

The presence of hCG after cystic drift, or rather, its concentration, is also important indicator in diagnostics. Usually after adequate treatment the amount of hCG after a cystic drift begins to decrease and normalizes by the 8th week. If no such dynamics is observed, and the amount of the hormone remains high, there is a possibility dangerous complication- malignant tumors of the trophoblast.

Bubble drift can provoke a number of complications:

- toxicosis in the form of necrotizing vomiting;

— early development arterial hypertension and preeclampsia;

- hyperfunction of the thyroid gland ();

- rupture of the formed ovarian cysts;

- infection of the contents of the uterus and the subsequent septic process;

- bleeding, especially in the invasive form;

- trophoblastic embolization: the penetration of vesicles from the uterine cavity into the pulmonary (through the vessels) and the development of the clinic of embolism;

- pronounced violations of the processes of blood coagulation, leading to.

Treatment of bladder skid

Any chosen tactic for the treatment of cystic drift is based on the need to remove the pathologically enlarged trophoblast. The specialist is faced with the task of choosing the most acceptable way to eliminate pathology.

The first stage of therapy for cystic drift is similar to abortion by vacuum aspiration. The method is suitable even with significant sizes (up to 20 weeks) of the uterus. After the contents of the uterine cavity are aspirated, an additional control curettage is performed to remove those small villi that are too tightly attached to the mucous membrane. In order for the uterus to return to its original state as soon as possible after the procedure, uterotonics are used - uterine-reducing agents (oxytocin, pituitrin).

Mechanical removal of the cystic drift is at the same time both therapeutic and diagnostic manipulation, since the study of the obtained tissues helps to clarify the diagnosis and study the laboratory cell composition of the material obtained. The presence of modified chorionic villi in the material indicates the reliability of the diagnosis of cystic drift.

The presence of rare and sometimes "dangerous" consequences of the diagnosis in the panel greatly scares the patients, especially if they seek to obtain additional information from not entirely reliable sources. In addition, each of them experiences stress from the thought of missed pregnancy and the death of a child. Therefore, before starting therapy, a detailed conversation is needed that:

- this pregnancy began to develop incorrectly, and it has no chance of becoming "normal";

- even the most unfavorable course of cystic drift does not exclude a complete cure;

- the next pregnancy after a cystic drift has every chance of being absolutely normal, subject to proper rehabilitation.

Often, it is also possible to self-expel the cystic drift, when, against the background of the introduction of reducing agents, the uterus independently evacuates the pathological contents.

The quality of the performed manipulation of the elimination of skidding is controlled ultrasound scanning, it is done several times at two-week intervals to ensure that the uterus and surrounding tissues are "cleaned".

Radiography of the lungs is indicated for all survivors of the procedure for removing the cystic drift in order to exclude the presence of metastases.

After removal of the cystic drift, it is also necessary to control the dynamics of hCG. Laboratory control is carried out weekly for the next two months.

A patient is considered healthy if:

- hCG after cystic drift after two months does not exceed 15 MMU / ml;

- ultrasound control does not detect tumors or metastases;

- radiographically "clean" lungs;

- menstrual function has recovered.

If the level of chorionic gonadotropin remains high eight weeks after the removal of the drift, there is reason to suspect the presence of trophoblast cells (in the uterus or other organs) remaining after the operation, which continue to secrete gonadotropin, or a malignant tumor of the trophoblast, therefore additional diagnostic measures are taken: examination, ultrasound diagnostics and radiography of the lungs. In such a situation, it is necessary further treatment chemotherapy, methotrexate and dactinomycin are used alone or in combination with leukoverin. Treatment continues until complete diagnostic well-being, the criterion of which is the absence of pathological foci and recovery normal performance HCG. In order to prevent relapses, chemotherapy drugs in a course dose are taken in two more courses.

Therapy with chemotherapy drugs allows to cure 100% (all) of patients with trophoblast pathology, and in 90% menstrual function returns to normal and does not need additional correction.

In the case when the cystic drift is complicated by threatening bleeding, preeclampsia, or other dangerous conditions, the treatment tactics changes: first, they compensate for the threatening condition, and then eliminate the cystic drift.

Destructive cystic drift cannot be eliminated by the aspiration method, because it literally grows into the uterine wall and vagina. The high probability of dangerous bleeding and rupture of the uterus is the basis for using a more radical surgical technique - it is performed (hysterectomy) along with pathological tissues.

In the case of a successful cure of the cystic drift, the patient is still observed by a specialist for at least a year, and then must be re-examined. A subsequent pregnancy, if needed, should be planned with your doctor. As a rule, pregnancy after cystic drift is recommended after the final follow-up examination, that is, after a year or more, provided good results... This recommendation is explained by the fact that if pregnancy occurs within a year after treatment, when a woman is under observation and undergoes control tests, the level of chorionic gonadotropin begins to rise, and it becomes impossible to understand what is causing its growth - a returned tumor or a real pregnancy.

Prevention of cystic drift

Like any pathology, cystic drift leaves negative consequences. Sometimes a woman who has experienced an episode of cystic drift has problems with subsequent conception, menstrual dysfunction occurs, or the risk of a pathological course of subsequent births increases. In children born in pregnancies after cystic drift, pathologies are recorded more often. Also, the risk of pathology in childbirth increases in those who give birth after cystic drift.

It should be remembered that after healing at the site of foci of cystic drift, wherever they are (uterus, vagina, lungs), small scars remain - areas of connective tissue. They persist for a long time even after complete recovery, but they dissolve over time, therefore they do not belong to complications.

And finally, the most adverse effect cystic drift is the formation of malignant degeneration (up to 20%).

Bubble drift is a rare and still poorly understood pathology. His main feature there is a clear connection with pregnancy, so it can be said that the absence of pregnancy is the only reliable measure for the prevention of the disease. However, such a measure, for obvious reasons, can be recommended only to those women who do not plan the desired pregnancy.

However, the lack of effective preventive measures does not interfere with the elimination of factors that, according to experts, can increase the risk of developing cystic drift. These can be roughly classified into those that are necessary for women planning pregnancy, and those that are already suitable for pregnant women.

When planning a pregnancy, women should first examine their health status and find out how prepared they are for a difficult and long period of pregnancy, as well as for childbirth. Since there is evidence of a higher risk of cystic drift in patients with infectious diseases and hormonal dysfunction, it is necessary to eliminate the source of infection and restore normal menstrual rhythm.

If the pregnancy has already taken place and is accompanied by a hydatidiform mole, the diagnosis should be made as early as possible. In addition to timely diagnosis, it helps Attentive attitude patients for pregnancy and the implementation of all recommendations given by the doctor.

In gynecology, there is a special section that includes the pathology of the trophoblast - a temporary organ that initially attaches the ovum to the uterus, and subsequently transforms into the fetal part of the placental septum. It is the trophoblast that is subsequently responsible for the nutrition of the fetus and shares its body with the mother's. One of the diseases of trophoblast is cystic drift. It refers to tumor processes, as it predisposes to the development of malignant cells, which occurs in 5-20% of cases.

Pathology is mainly detected in young women (23-25 ​​years old) and in pregnant women after 37 years old and should be differentiated from other trophoblast diseases, which often become its complication:

  • choriocarcinoma;
  • swelling of the placenta bed;
  • epithelioid tumor of the trophoblast.

Bubble drift is a rare disease (up to 0.02-0.7% among pregnant women), it arises from the tissues involved in the formation of the membranes and, if untreated, can grow deeply into the tissues of the uterus. Characteristic features of cystic drift - severe swelling stroma, proliferation of chorionic villi, the formation of vesicles in the form of bunches of grapes.

Inside the bubbles, reaching 2-3 cm, there is a liquid medium. It includes chorionic gonadotropin (hCG), proteins and other compounds. Vesicles are rarely supplied with blood, only occasionally small single capillaries are present on them. A large number of hCG hormone causes the appearance of cysts on the ovaries, as well as other disorders in the body. Thus, with a cystic drift, instead of the normal development of the embryo, a bubble-like proliferation of chorionic villi occupying the entire uterine cavity occurs. The embryo itself most often dies immediately.

Bubble drift: classification

There are such types of pathology:

  1. complete blistering skid;
  2. incomplete cystic drift (partial).

Complete cystic drift is a disease in which there are no embryonic tissues at all, that is, the regeneration of the chorionic villi covers their entire area. As a rule, this type of disease is found at 11-25 weeks of gestation.

Partial hydatidiform moles are manifested by the same clinical signs, but there are separate elements of the ovum with it. Pathological changes affect only part of the chorionic villi. Partial cystic motility is usually diagnosed 9-34 weeks after conception, that is, at almost any gestational age.

According to the degree of invasion, the disease can be:

  1. Simple hydatidiform mole. Chorionic villi are large, edematous, located inside the uterine cavity.
  2. Proliferating cystic drift (destructive). In this case, chorionic villi grow deep into the muscular layer of the uterus, destroying its tissues. This type of illness often leads to life-threatening bleeding.

Why does cystic drift occur?

The causes of cystic drift lie in anomalies in the development of the embryo. In the study of a partial vesicular mole, it was found that its set contains a maternal and two paternal chromosomes. Thus, the egg is fertilized by 2 sperm at once, as a result of which extra chromosomes are present in the embryo, and it itself is not viable. This type of pathology degenerates into cancer in 5% of cases.

The causes of complete gallbladder drift consist in the fertilization of a defective female reproductive cell, in which there is no set of chromosomes. As the embryo develops, the father's chromosomes double, but instead of the development of the ovum, a bubble-like transformation of chorionic villi is observed. When diagnosed, two X chromosomes are found, which are paternal. Occasionally, paternal chromosomes form the 46XY karyotype (no more than 13% of cases). Malignant transformation of the disease is diagnosed much more often (up to 20% of pathologies).

Sometimes cystic drift is a consequence of an ectopic (tubal) pregnancy, so it is localized in the fallopian tube.

Clinical presentation: how to identify a hydatidiform mole

Symptoms of a cystic skid on initial stage practically do not appear, therefore, the course of pregnancy is normal and with the development of the disease may not differ. Subsequently, signs of cystic drift make themselves felt against the background of excess production of hCG in the form of severe morning nausea, vomiting. Partial cystic drift has less pronounced symptoms, complete, and especially invasive, already from 5-7 weeks can give a vivid clinical picture:

  • Discharge of blood (in almost 100% of cases), which occurs due to flaking children's place from the membrane (the blood is dark, includes small separated bubbles). Sometimes the blood flows profusely, which causes a sharp decrease in hemoglobin.
  • Inadequate growth of the uterus. Due to the fact that the bubbles of the chorionic villi grow very quickly, the size of the uterus becomes larger much faster than during a normal pregnancy.
  • Toxicosis with indomitable vomiting, salivation, electrolyte imbalance (this occurs with the participation of the hCG hormone).
  • Symptoms of severe gestosis, including preeclampsia, eclampsia, liver failure with edema, proteinuria, increased blood pressure. Salient feature cystic drift - the appearance of signs of preeclampsia from the 1st trimester.
  • Increase in thyroid-stimulating hormone to the level of hyperthyroidism. More often this symptom is observed with a complete cystic drift. Usually, pathology occurs if the level of hCG is significantly increased in a pregnant woman.
  • Luteal cysts on the ovaries. Against the background of a high level of hCG, half of the patients develop large cysts (up to 15 cm), since the hormone continuously stimulates the ovaries. After deleting hCG drift normalizes, and the cysts spontaneously resolve. Due to the presence of cysts big size a woman can be tormented by pain, pressure, distention inside the abdomen.

If the cystic drift grows into the myometrium of the uterus, there are acute, cutting pains... Since after the malignant transformation of the skid, metastasis occurs quite quickly, even during pregnancy, a woman may begin to worry about hemoptysis (with metastases to the lungs), headaches, visual impairments (with metastases to the brain).

Possible complications of cystic drift

If the pathology is invasive, its complication can be perforation of the uterine wall and massive hemorrhage into the peritoneum. Branch embolism is possible as a result of severe eclampsia pulmonary artery with respiratory failure, pulmonary edema. Sometimes cystic drift is complicated by vascular thrombosis, intrauterine infections, and even after removal can cause infertility.

Serious consequences of gallbladder drift are the development of choriocarcinoma, a malignant gestational trophoblastic tumor. This tumor quickly metastases to the vagina, vulva, as well as to distant organs (brain, lungs, liver, kidneys). Without surgery and chemotherapy, this type of cancer can be fatal.

Diagnostics of the cystic drift

Usually, with the development of the disease, the fetus dies in the first weeks of pregnancy, and therefore the heartbeat and other signs of normal gestation are not determined by ultrasound. But due to the production of the hCG hormone by the cystic drip, the pregnancy test always gives positive result... Without a medical examination, pathology can be suspected by the presence of bleeding, lack of motor activity of the child according to the timing.

Methods for diagnosing cystic drift include:

  1. Ultrasound. Usually, instead of a normal embryo, a variegated picture is revealed due to the presence of drift bubbles. In addition, cysts on the ovaries can be found in some women.
  2. Blood test for hCG. The level of the hormone exceeds that characteristic of a particular gestational age. Additionally, after removal of the drift, an analysis is carried out for hCG once a week for 8 weeks, then once a month for another 6 months.
  3. Gynecological examination. The doctor can see the swelling through the internal os of the cervix.
  4. Histological examination of tissues. It is carried out after the treatment has been performed. Bubble drift necessitates the referral of a woman to the oncology department of the hospital after receiving the results of histology.
  5. X-ray of the lungs, brain. It will be required if you suspect metastases.

If even after the treatment hCG indicators are not normalized, more thorough examination involving narrow specialists... This fact may mean that the tumor cells have spread to other areas of the body.

How is cystic drift treated?

Now the disease is being treated surgically, supplementing it with chemotherapy if necessary. In parallel, new tests are being carried out, which are aimed at improving the existing methods. Most often, in the absence of cancerous tissues in the cystic drift, curettage is performed by step-by-step curettage. The tissues of the uterus are stretched, after which drugs are injected to reduce its walls (pituitrin, oxytocin) and the entire contents of the organ are evacuated. Then the walls of the uterus are scraped out so that there are no drift particles left. After it's over surgery cystic drift, chemotherapy is prescribed (if necessary). It aims to destroy individual cancer cells that are not visible to a specialist during surgery.

In some cases, you will need complete removal uterus (hysteoctomy). This is necessary if a malignant tumor is already developing against the background of a cystic drift. The ovaries are usually preserved. Extirpation of the uterus (its removal without the cervix, ovaries and tubes) can be urgently done in the presence of life-threatening bleeding.

If the patient wishes to have children in the future, chemotherapy is first performed (Methotrexate, Leurovorin, Dactinomycin are used in combination more often), and only if this method did not help completely eliminate the tumor, the uterus is removed. If there are metastases, a decision may be made to apply radiation therapy to the immediate area of ​​cancer. As mentioned above, after treatment, a weekly (later monthly) is required. hCG diagnostics in the blood, as well as regular ultrasound examinations. On dispensary observation the woman is at least 2 years old, and during this period she takes hormonal contraceptives.

Is pregnancy possible after removal of the cystic skid?

If the diagnosis of the disease was timely, and the treatment was adequate, this will help preserve the woman's fertility in the future. If chemotherapy is not required, then the hCG hormone will normally disappear from the blood in 5-6 months. After treatment with chemotherapy, the doctor will recommend not planning conception for 1-2 years, since pregnancy after cystic drift, which occurred earlier, will not allow assessing the severity of the situation. The fact is that the chorionic gonadotropin increases in pregnant women, and it will be unclear whether such an increase was caused by a recurrence of cystic drift (this happens in 2% of cases).

Fortunately, if the organs were not removed reproductive system, the transferred illness does not affect conception in the future. More than 70% of women, after elimination of the pathology, can have children. To further exclude such problems, a woman is advised to carefully plan a pregnancy, as well as be monitored by ultrasound from the first weeks of gestation and assess the level of hCG. Usually, pregnancy proceeds normally, but there is evidence of a slightly more frequent weakness of labor, bleeding during childbirth in women who have previously undergone trophoblast pathology.

Recovery prognosis

Timely use of surgery and chemotherapy in combination can heal up to 100% of women, and 90% of them are recovering menstrual cycle... Even in the presence of pathological foci in distant organs, they are completely destroyed, but after that connective tissue cords and scars remain.

Invasive types of drift have a more serious prognosis, as well as the development of choriocarcinoma, or tumor recurrence in other organs after treatment. Re-emergence of a tumor, or resistant trophoblastic disease, is diagnosed in 15% of cases after a complete skid. Such an outcome of events will require additional chemotherapy courses until complete recovery (sometimes they last several months). In the presence of choriocarcinoma metastases, the prognosis is favorable in 70% of cases.

How to prevent the development of cystic drift

Surely it is almost impossible to prevent the development of pathology, but measures that contribute to the normal course of pregnancy and the development of the baby can be giving up bad habits, preventing abortions, planning pregnancy together with an obstetrician-gynecologist after passing all the necessary tests, early staging registered.

Bubble drift is the pathology of the ovum, as a result of which the chorionic villi degenerate into vesicles with liquid, the epithelium and syncytium grows. The disease does not differ in frequency - it is estimated in one case in 1000 pregnancies. Medical practice knows cases of cystic drift that are not associated with pregnancy, when a chorion is formed in the uterus, and chorionic gonadotropin is contained in the blood.

Distinguish between complete and incomplete cystic drift, the mechanisms of development of which have some differences:

  • complete cystic drift is characterized by the absolute absence of embryonic tissue, which occurs due to the fertilization of a defective egg, for example, one that does not have chromosomes; even a further doubling of the paternal chromosomes leaves such a zygote unviable - the embryo does not arise, but only the chorionic villi grow; usually develops in the first trimester of pregnancy;
  • incomplete cystic drift is a consequence of the fertilization of the egg with two sperm, which again provokes a violation of the chromosomal set, and such a zygote is extremely rarely viable and full-term pregnancy is a huge rarity; usually develops in last trimester pregnancy, the fetus dies if more than a third of the placenta is damaged, and childbirth threatens to be premature.

An expanding cystic drift produces an excessive amount of chorionic gonadotropin, which does not correspond to the gestational age, and if this occurs outside of pregnancy, it is considered a pathology in itself. An excess of hCG causes the formation of luteal cysts in the ovaries, and in individual cases the skid develops into chorionepithelioma (a malignant tumor prone to penetration into healthy tissues and to rapid metastasis).

Causes of cystic drift are called the following:

  • fertilization of an egg with two spermatozoa, it is not possible to predict that;
  • fertilization of a nuclear-free cell, as a result of which the zygote develops abnormally - it does not contain maternal chromosomes;
  • damage to the trophoblast (merged egg and sperm) by malignant cells as a consequence of trophoblastic disease; it originates in the womb.

Scientists still have not succeeded in explaining and reducing the risks of unwanted pathology of the fusion of the egg and sperm.

The risk group includes women of mature age (over 40 years old) or young girls (up to 20 years old). Some experts observe a relationship between the likelihood of cystic drift and the number of pregnancies - so it is argued that cystic drift is less likely in the first pregnancy. Bladder drift is diagnosed even in childhood, but this is rare, and a third of cases occur in the premenopausal period.

Cystic Skid Symptoms very specific. The development of the disease cannot go unnoticed. The manifestations of cystic drift extend to the entire body and are represented, in particular, by such ailments and disorders:

  • uterine bleeding leading to anemia;
  • indomitable vomiting, entailing the need for parenteral administration of fluids, electrolytes and antiemetics;
  • arterial hypertension;
  • moisture and hyperemia of the skin;
  • sometimes an increase in the thyroid gland and the development of thyrotoxicosis;
  • sometimes tachycardia and tremor due to thyrotoxicosis;
  • rarely pulmonary embolism by trophoblast cells, which means shortness of breath, cyanosis, cough.

A blistering mole will be suspected by the doctor examining the woman if

  • a woman complains of frequent toxicosis, anemia,
  • the size of her uterus exceeds the appropriate time frame
  • there are no reliable signs of pregnancy, such as heart sounds and movements of the fetus, its part.

Bladder motility is considered a disease prone to frequent relapses. Recurrence of the disease means the recurrence of the tumor after the treatment. The malignant process sometimes reappears in the pancreas or in any other organs and tissues.

How to treat a hydatidiform mole?

Bubble drift, if this diagnosis is confirmed, is considered an indication for immediate hospitalization... A woman is advised to immediately eliminate it due to the fact that delay is dangerous with bleeding, thyrotoxicosis and arterial hypertension. Removal of cystic skid is possible by two of the most popular methods:

  • if there are plans to become pregnant in the future, vacuum aspiration is prescribed - it is carried out under general anesthesia, with the use of oxytocin in combination with glucose; artificially with the use of kelp sticks, the cervix expands, then scraping is performed with a sharp curette; both seized biometrics are sent separately for histological examination;
  • in the absence of plans for future motherhood, the woman will be offered uterine extrusion, which is certainly radical, but excludes any risks of further relapse.

Before surgery, a woman is analyzed to determine the Rh factor and with negative indicators during treatment of cystic drift the administration of anti-Rh0 (D) -immunoglobulin to a woman is strongly recommended.

Often, chemotherapy and radiotherapy are used as additional methods of treating cystic drift. This is prescribed in the postoperative period if the histological examination of the seized material has given reason to believe the presence of malignant processes. Chemotherapy in this case is represented by pill forms of drugs, and radiotherapy is either external (using a special apparatus located outside), or internal influence(using radioisotopes delivered locally through thin plastic tubes).

The prognosis for such a pathology is often favorable, especially when the treatment was performed efficiently and in a timely manner. The likelihood of new pregnancies with a normal course is highly assessed.

What diseases can it be associated with

Bubble drift is considered one of the consequences. Trophoblast disease, or gestational trophoblastic tumor, is a rare malignant disease that occurs in women in which tumor cells invade the tissues that form the trophoblast (the result of the fusion of the egg and sperm). Its second manifestation and degeneration of skidding is, however, it is also directly related to skidding, because it is its malignant transformation. Chorionic carcinoma is a malignant tumor prone to invasion into healthy tissues and rapid metastasis.

Bubble drift is manifested by the following dysfunctional disorders:

Treatment of bladder skid at home

Treatment of bladder skid at home it is not carried out due to the fact that the condition is critical and requires urgent hospitalization. It is in the conditions of hospitalization that it is possible to remove the cystic drift by means of surgical intervention... Even in the postoperative period, the patient is recommended to be regularly monitored by a specialized specialist for a timely response to a recurrent manifestation of the disease.

What drugs are used to treat cystic drift?

The drugs used for bladder drift are predominantly chemotherapy drugs. The latter is realized either using one medication, or a combination of them:

  • monochemotherapy in 5-day cycles at 5-7-day intervals, up to a total of 8 cycles:
    • - 75 mg per day,
    • - 1500 mcg per day,
    • - 1.0 g per day,
    • - 50 mg per day;
  • polychemotherapy is usually a five-component combination of EMA-CO Recommended for high risk of antineoplastic resistance.

Treatment of cystic drift with alternative methods

The elimination of cystic drift with folk remedies is fraught with serious complications. In no case should folk drugs be used as the main method, if there is confidence in such drugs, then their use should be agreed with the attending physician and be only an addition in the postoperative period or at the stage of chemotherapy / radiotherapy.

Treatment for bladder moles during pregnancy

Cystic motility during pregnancy is considered an extremely undesirable condition, and dangerous to the health of the mother, and lethal to the fetus. If a pregnant woman has a pathological transformation of the ovum and the degeneration of the chorionic villi, if this is proven during examinations, then the only way to save life and restore health (including for subsequent pregnancies) is to remove the cystic drift, which, of course, excludes the possibility of continuing pregnancy.

Removal of cystic motility in early pregnancy occurs by the same methods as in non-pregnant women. That is, vacuum aspiration and scraping, curettage are used. If the size of the uterus differs in size, then a small cesarean section... A minor cesarean section is a way to artificial interruption late pregnancy (more than 13 weeks), prescribed for medical reasons.

Which doctors should I contact if you have a cystic drift?

Bubble drift, being a manifestation of trophoblastic disease, in the process of its diagnosis requires the doctor's confidence in the details of the development of trophoblastic pathology. Trophoblast disease in the early stages and before pregnancy is difficult to detect, and therefore even pregnancy in the early stages develops normally. Towards the middle of pregnancy, atypical bleeding develops and indomitable vomiting, later the child does not give movements. This becomes the reason for a detailed diagnosis for trophoblastic disease and cystic drift.

An unconditional sign of a cystic drift for a gynecologist observing a woman is the release of cystic chorionic villi from the uterus. If there are none, then the methods of detailed diagnostics are used, these are:

  • ultrasound is prescribed if there is a homogeneous fine-grained mass in the uterus;
  • urine analysis for indicators of chorionic gonadotropin - suspicions of pathology are removed when hCG values ​​are not more than 500,000 IU / L in daily excretion for a period later than 12 weeks; however, the conclusion cannot be considered the only correct one, it is rather indicative;
  • analysis of blood serum for the content of the beta-subunit of hCG - suspicions of pathology are finally removed when the beta-subunits of hCG are not more than 100 IU / L at 12-14 weeks of gestation.

Trophoblastic disease and cystic drift as its consequence in rare cases, however, it is diagnosed in women who are not in position. Those with characteristic complaints are sent for a vaginal examination, where the doctor, by palpation of the abdomen, detects swelling and neoplasms in the uterus, the same is possible through ultrasound. The presence of chorionic gonadotropin in the blood, which is detected by analysis, outside the period of pregnancy is taken as a pathology and sure sign trophoblast diseases.

Histological examination of the biomaterial extracted from the uterus as part of the treatment finally confirms or refutes the diagnosis, and the patient will be recommended to be monitored in a specialized oncological institution. In the absence of threatening signs of relapse within the next two months (based on weekly blood tests and ultrasound examination organs of the small pelvis), for another three months (based on similar examinations every two weeks) and during the next six months with a monthly examination are indicators of recovery. The optimal period for the onset of the desired pregnancy is a year after the evacuation of the cystic drift.

Treatment of other diseases with the letter - p

Pancreatitis treatment
Treatment of pancreatic necrosis
Treatment of papilloma of the trachea
Parametritis treatment
Treatment of paraneoplasias
Treatment of paranephritis
Head lice treatment
Pelvioperitonitis treatment
Testicular torsion treatment
Patella fracture treatment
Shoulder periarthritis treatment
Pericarditis treatment
Hepatic coma treatment

Bubble drift is a pathological condition in which, instead of long-awaited pregnancy in the woman's uterus, the trophoblast (a temporary organ necessary for the attachment of the ovum to the walls) is degenerated into a huge number of small vesicles. With such a pathology appearance the ovum resembles bunches of grapes. The embryo with such a pathology dies in the early stages of pregnancy.

Classification

In medical practice, there are several types of pathology such as cystic drift. The primary classification divides this disease into two forms: simple and invasive. When we are talking about a simple form, we mean the formation in the uterine cavity of a cystic drift, which has a certain localization and does not affect the organ tissues located near it. In the invasive form, the cystic drift grows into the walls of the uterus, which leads to tissue destruction and possible perforation, with the development of massive intra-abdominal bleeding.

Another classification divides this pathology into two forms: partial and complete. Most often, there is a complete cystic drift, in which it contains a diploid set of chromosomes, both of which belong to the father. If we talk about a partial cystic drift, then it occurs when the transformation does not affect all the villous layers of the chorion. Sometimes, with this form of the disease, a triploid set of chromosomes can occur, of which one is maternal and two are paternal.

Diploid set of chromosomes with cystic drift full form it is noted mainly in those cases when it was formed in the early stages of pregnancy. Triploids occur if partial bladder motility develops between 9 and 30 gestational weeks. In this case, and in fact, and in that case, the fetus in mother's womb dies, but if a complete cystic drift occurs at an early stage, the embryo is not found in the fertilized egg at all. With such a violation as a partial cystic drift in fetal egg unchanged particles of the fetus and placenta can be found, while with complete they are absent altogether.

There is also a classification of such a pathology as cystic drift, in accordance with the gestotype, that is, depending on which cells of the trophoblast undergo degeneration. According to this classification, there are three types of pathology: cytotrophoblastic, syncytial and mixed.

Reasons for development

Since gallbladder drift is a chromosomal pathology that occurs during gestation, it is impossible to determine exactly what leads to the development of such disorders. At the same time, the causes of gallbladder drift lie in the fact that during fertilization, maternal genes are lost, and paternal genes, replacing them, are duplicated.

In addition, pathology can occur if an egg that does not have a nucleus is fertilized by two sperm.

If we talk about risk factors, then several times more often this disease occurs in women who are either not ripe for pregnancy (14-15 years old), or are already over 40 years old. Multiple childbirth, abortion, lack of certain microelements and vitamins in the diet, immunodeficiency, as well as the creation of families between close relatives - all these factors can cause the development of this serious pathology in a woman during pregnancy. Fortunately, this phenomenon is quite rare - on average, it occurs in 1 pregnant woman in 1000, although these indicators are relative.

Clinical manifestations

The symptoms of this pathology are ambiguous - they can manifest themselves in different ways in different women. As the skid forms on different stages pregnancy and can be of different forms, this is the defining criterion of the clinical picture.

However, the main symptoms that can bother a woman with this disorder are:

  • after a long period of delay in menstruation, she develops uterine bleeding with dark blood which can be mild to profuse;
  • which many women mistake for pregnancy symptoms are nausea and vomiting, lack of appetite and exhaustion, drooling and dizziness.

In severe cases, when a cystic drift grows into the walls of the uterus, causing their destruction, intraperitoneal bleeding may occur, and if the woman does not receive urgent treatment, the likelihood of death is very high. Also, one of the indicative symptoms of complete cystic drift is the discrepancy between the size of the uterus and the gestational period of pregnancy, which is confirmed by both visual examination and ultrasound.

Another characteristic symptom of this pathological condition is the presence of bilateral fluid cysts of the ovaries, which in size can reach 10 cm or more. They are easy to detect on ultrasound, but not all women with cystic moles develop them. Treatment of such cysts is not carried out, since they disappear on their own after the uterine cavity has been cleaned from cystic drift.

Separately, it should be said about hCG with cystic drift - its level is several times higher than the norm. Therefore, during treatment, it is mandatory to check it before the period when it does not return to normal. At the same time, after treatment, when the hCG level is normalized, a woman will still have to regularly take this test for six months with preventive purpose... Signs of a cystic drift of a partial form can mimic its signs in the early stages of pregnancy, therefore, it is problematic to diagnose a violation during this period.

Separately, it should be said about the severe complication caused by cystic drift - its transition to a malignant form, due to the spread of bubbles in various bodies, mainly in the lungs. Very often, women with this pathology are faced with the development of chorionepithelioma (choriocarcinoma) after removal of the cystic drift. The prognosis of the course of the disease in this case is extremely unfavorable - in most cases, death occurs. Therefore, the earlier a pathology is detected and its treatment is started, the higher the likelihood that the process will regress irrevocably, and the woman's health will suffer minimally.

Other complications of the pathology are:

  • septicemia;
  • intrauterine infection.

Diagnostics and treatment

Diagnosis of the disease is based on a gynecological examination of the patient and palpation of her uterus, with the establishment of the size, consistency and density of the organ. also in mandatory ultrasound is prescribed. Moreover, it is ultrasound that is the most informative method that allows you to see a cystic drift.

Ultrasound can be either external or vaginal. During ultrasound, bilateral fluid cysts of the ovaries may be found, and, in addition, the absence of the fetus in the uterus can be seen. Phonocardiography shows the absence of a heartbeat in the fetus, which is also diagnostic sign... Also, for the differential diagnosis of this pathology with others, hysteroscopy, CT and MRI may be required.

Laboratory tests are necessarily carried out - the level of hCG is determined, biochemical samples of the liver are taken and a coagulogram is prescribed.

As for the treatment, it is extremely fast. For this purpose, vacuum aspiration devices are used, followed by cleaning the uterine cavity using curettage. With such a pathology as a simple cystic drift, sometimes it is spontaneously removed from the uterus. In this case, vacuum aspiration is still performed in order to make sure that there is nothing left in the uterus. And the material extracted from the uterus is sent for research to confirm or refute the malignant transformation of cells. With an invasive form, the risk of bleeding is high, and upon finding this form on an ultrasound scan, the doctor must urgently hospitalize the woman in a hospital and prescribe to her surgical treatment with removal of the uterus and preservation of the ovaries (if possible).

In cases where the disease has a malignant course, chemotherapy is indicated, the regimen and drugs for which are selected individually for each patient. After treatment, patients are also shown a diagnostic ultrasound scan to examine the uterine cavity.

Many women are interested in whether pregnancy is possible after a cystic drift. There is no unambiguous answer to this question, since a lot depends on the woman's age, her state of health and complications caused by pathology. According to studies, 30% of women after this pathology suffer from infertility, but if it was detected in a timely manner and the treatment was carried out with high quality, then the chances of becoming a mother are good for a woman.

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Diseases with similar symptoms:

It is no secret that microorganisms are involved in the body of every person during various processes, including the digestion of food. Dysbacteriosis is a disease in which the ratio and composition of microorganisms inhabiting the intestine is disturbed. This can lead to serious disruption of the stomach and intestines.

Gallbladder (molar pregnancy) is a rare complication of pregnancy that affects about one in a thousand women. It occurs when the chorionic villi - the shell that surrounds the fetus and attaches it to the wall of the uterus - degenerates into vesicular structures that resemble bunches of grapes. Their size is very different: from half a match head to a large grape. These neoplasms are considered benign.

In pregnant twins, in rare cases, one fetus can develop normally, and the second embryo does not form or dies as a result of cystic drift. In such cases, many women can endure and give birth healthy child.

What Happens During A Blister Skid?

In a normal pregnancy, the fertilized egg cell (zygote) begins to divide, and upon reaching a certain amount cells, they are divided into two groups: from one the embryo is formed, from the other - the fetal membranes, including the chorion. Bubble drift develops in two cases:

  1. a sperm cell fertilizes an egg that does not have its own nucleus. In the future, the paternal chromosomes are doubled, thus replacing the missing maternal ones. But such a zygote is not viable, the embryo does not form from it, and the chorionic villi turn into abnormal vesicles. This type of bladder skid is called complete.
  2. two spermatozoa enter a normal egg at the same time. Zygote cells contain 3 sets of chromosomes, which leads to the death of the embryo in the early stages of development. Chorionic villi also develop abnormally and form vesicles. This pathology is called incomplete cystic drift.

Causes of blistering skid

The causes of cystic drift have not been established at this time. But there are known factors that increase the risk of its development:

  • age: full bladder skid occurs in adolescence and those who are over 45 years old. In this case, the number of previous pregnancies does not matter. A significant relationship between incomplete skidding and age has not been established;
  • history of molar pregnancy - if a woman had such a pathology earlier, the chances of re-development are regarded as 1-2% (without such experience, 0.6%). Two or more gallbladder drifts increase this figure to 15-20%;
  • ethnicity: such a complication of the course of pregnancy is most often found in representatives of Asian countries (Philippines, Japan, Taiwan);
  • previous miscarriages.

Symptoms

A molar pregnancy is often perfectly disguised as a normal pregnancy, and the diagnosis is usually made during the planned first ultrasound scan (at 10-14 weeks of pregnancy).

If there are signs of abnormalities, they usually appear between the 4th and 12th weeks. The most common symptom is uterine bleeding, a brownish-reddish vaginal discharge that sometimes shows altered chorionic villi resembling a bunch of grapes. These are serious symptoms that require immediate medical attention. Standard diagnosis of the causes of bleeding includes an ultrasound scan, during which a picture characteristic of a cystic drift is found.

Many women who are subsequently diagnosed with a molar pregnancy experience weakness and nausea in the first semester, usually more intense than during normal bearing of a child.

If a miscarriage occurs, the tissues of the embryo must be sent for research in order to exclude cystic drift.

At medical examination may reveal other signs of cystic drift:

  • uterus has big sizes than it is typical for the current term;
  • high blood pressure;
  • preeclampsia;
  • ovarian cysts;
  • anemia;
  • hyperthyroidism;
  • lack of movement and fetal heartbeat.

Diagnostics

Diagnosis begins with a conversation with a doctor. It is very correct to prepare answers to some questions in advance:

  • date of your last period?
  • when were the symptoms first noticed?
  • Are the unpleasant sensations persistent or occur from time to time?
  • is there any pain? if so, what is the nature and intensity of the pain?
  • compared to the most intense day of normal menstruation, the discharge is stronger, weaker, the same?
  • Does dizziness bother you?
  • Have you previously been diagnosed with a hydatidiform mole?
  • what chronic diseases are there?
  • are you going to get pregnant in the future?

The next steps to confirm the diagnosis are - gynecological examination and laboratory diagnostics... A woman's blood is taken for general and biochemical analysis, determine the level of chorionic gonadotropin, send for ultrasound of the abdominal cavity. If molar pregnancy has already been diagnosed, then in a number of other cases, using visual diagnostic methods (X-ray, CT, MRI), they check for metastases in the lungs, brain, and liver.

Treatment of bladder skid

Bubble drift cannot end with the birth of a child (with the exception of twins). Therefore, when such a pathology is detected, the pregnancy is interrupted. Sometimes the body independently cleans the uterine cavity from cysts that come out with secretions. If this does not happen, they are removed surgically. Usually under general anesthesia. Standard procedure called dilation and curettage of the uterus. During it, the doctor, using a gynecological mirror, gains access to the cervix, opens it and vacuum apparatus removes the contents of the organ cavity.

It is difficult to get rid of absolutely all pathological cells. Fortunately, after surgery, 90% of women die on their own.

To ensure the success of treatment, women regularly donate blood for 6 months or more to control the level of human chorionic gonadotropin (HCG). If at the end of this period the hormone is still present in the blood, this may indicate a relapse of the disease or the degeneration of benign growths into malignant ones. Normally, the hCG hormone is secreted during pregnancy. Therefore, women are asked to refrain from conceiving for six months to a year in order to avoid misinterpreting the results, and in the case of incomplete removal of the abnormal chorionic tissues, the development of repeated molar pregnancy.

For women who no longer plan to have children, removal of the uterus (hysterectomy) may be recommended.

Alternative treatment of cystic drift

There are many “grandmother's” recipes on the Web that seem to help cure molar pregnancy. But none of them has proven to be effective. The time spent on ineffective procedures can be enough for the transformation of a benign neoplasm into a malignant one, which is much more difficult to treat.

Complications

In some cases, unremoved cells do not die, but continue to multiply, forming more and more cysts (recurrent cystic drift). Worst case- transformation of a tumor into a malignant choriocarcinoma. Cancer cells penetrate into the tissues of the uterus, sometimes growing through and through and provoking internal bleeding. When growing into the vessels, tumor cells are carried with the blood to the organs and form metastases, most often in the lungs, brain or liver.

Chemotherapy is highly effective if choriocarcinoma and recurrent hydatidiform mole is diagnosed early. Relapse after cure occurs in approximately 1-3% of women. It is imperative to control the level of hCG, since this indicator helps to notice the re-development of the disease in time and to start the course of chemotherapy in a timely manner.

Forecast

A complete cure is possible in most cases. Only 1% of women may have a second disease in the future. After the second molar pregnancy, the risk of developing a third is much higher - up to 15-20%.

In rare cases, benign neoplasms become malignant. But even with this option, chemotherapy leads to a complete recovery in 90% of women.

Emotional complications

Subsequent pregnancies

Re-pregnancy should be planned only after the entire period of HCG control has been completed. V further woman has a good chance of conceiving, carrying and giving birth to a healthy child. A doctor leading a pregnancy must be aware of previous blistering drifts, as well as other features of previous pregnancies. Since women with a diagnosis that have already been diagnosed are at a slightly higher risk of developing it, they may be recommended to have the first ultrasound scan earlier than with the standard examination scheme.