Future mother 

How dangerous is blistering? Bladder drift is a rare pathology that threatens pregnancy.

One of the unpleasant and, moreover, formidable complications of pregnancy is hydatidiform mole. Some consolation for women who are already “in position” can be the fact that this pathology is not so common and is approximately 1 case per 1000 births. The researchers noted that the prevalence of the disease is directly related to geographic and racial origin. For example, in the United States, there are 0.6 - 1.1 cases of hydatidiform mole per 1000 of all pregnancies, while in Asia (not all) and in South America it is diagnosed approximately 10 times more often.

What is a blister?

Cystic drift is the pathology of the trophoblast, as a result of which the stroma swells, and the chorionic villi grow. At the ends of the chorionic villi, expansions are formed in the form of bubbles, similar to bunches of grapes. Bubbles or cysts increase to 0.25 cm, inside they contain a yellowish liquid with a high level of human chorionic gonadotropin (CG).

The described pathology is included in the group of trophoblastic diseases, the development of which is associated with pregnancy. Trophoblast tumors are the only ones of all cancerous tumors that originate from the trophoblast, which is a derivative of the female and male germ cells. A hydatidiform mole can develop during an ongoing pregnancy, after childbirth, and even after an ectopic pregnancy.

Types of hydatidiform mole

Depending on the area of ​​regenerated chorionic villi, there are full and partial hydatidiform mole. With complete cystic drift, the embryo dies even in the early stages of pregnancy, and all the villi are involved in the pathological process. With partial mole, only part of the chorionic villi is reborn, it usually develops in the second half of pregnancy, but can occur earlier or later, in terms of 9 to 34 weeks. It is possible to have a live fetus in the case of an almost full-term pregnancy.

Also, hydatidiform mole can be simple and destructive or invasive. The destructive form is characterized by the fact that chorionic villi sprout (introduce) into the muscular wall of the uterus, which is fraught with internal bleeding. This is the most severe form of the disease.

Causes of hydatidiform mole

To date, the exact causes of the pathology have not been established. There are several theories for the development of hydatidiform mole:

  • the theory of viral transformation (the viral nature of the disease matters);
  • disease of the egg in the ovary (a pathological egg that has matured in the follicle causes the death of the embryo);
  • decidual theory (decidual endometrium causes the degeneration of the chorion);
  • immunological theory;
  • enzymatic theory (increased content of hyaluronidase, which destroys the vascular wall);
  • protein deficiency (lack of genes in the chromosomes of a fertilized egg).

The full form of hydatidiform drift is caused either by the loss of maternal genes, in which case the father's genes are duplicated, or by the simultaneous fertilization of an egg without a nucleus by two sperm. Partial hydatidiform mole occurs when there is an existing pathology of spermatozoa (dyspermia or a spermatozoon that has fertilized an egg has a diploid set (doubled) of chromosomes). In this case, the zygote will not contain 46 chromosomes, but 69.

Predisposing factors for the development of hydatidiform mole include:

  • age (20 - 24 years and 40 - 49 years);
  • parity (large number of births);
  • multiple abortions;
  • thyrotoxicosis;
  • immunodeficiency;
  • lack of vitamin A or carotene in food;
  • consanguineous marriages.

Symptoms of hydatidiform mole

The clinical picture of cystic drift is not always clearly expressed. It is possible to diagnose the disease during an abortion, which is often an accidental finding. In most cases, a woman considers herself pregnant, she has a delay in menstruation. There are signs of early (nausea, vomiting, dizziness, fatigue, and others) in the first trimester of pregnancy and severe symptoms (up to) in the second half of pregnancy.

Also a symptom of cystic skidding are uterine bleeding, which occurs early. Sometimes in bloody secretions, bubbles can be found that have come off the chorionic villi. Bleeding can also be internal, into the abdominal cavity, which indicates a destructive form. Blood loss leads to anemia in the patient with all the ensuing consequences (weakness, fainting, increased fatigue, etc.).

When conducting a gynecological examination, the doctor often determines that the size of the uterus does not correspond to the gestational age. A significant increase in the size of the uterus (for example, pregnancy 8 weeks, and the uterus is palpated as 12 weeks old) is characteristic of a complete mole. The consistency of the fruit-place is heterogeneous, in some places strongly softened areas are palpated, which alternate with dense elastic ones. If the pregnancy has exceeded 20 weeks, the fetus and its large parts are not detected. The baby's heartbeat is also not audible.

In half of the cases with cystic drift, bilateral luteal ovarian cysts are diagnosed. Their sizes exceed 6 cm in diameter and can reach 15 cm.

Treatment of hydatidiform mole

At the first stage of treatment, it is necessary to remove the cystic drift. To do this, use the following methods:

  • curettage of the uterine cavity;
  • vacuum excochleation;
  • finger removal followed by curettage;
  • labor induction after 20 weeks of gestation with prostaglandins, in the absence of effect - caesarean section with curettage;
  • extirpation of the uterus without appendages (luteal cysts disappear on their own within 3 months after removal of the cystic mole).

In the postoperative period, cold is shown on the lower abdomen (for 2 hours), reducing drugs (oxytocin), antibiotics and infusion therapy (if indicated). After being discharged from the hospital, the woman is registered in the dispensary at the antenatal clinic. The restoration of a regular menstrual cycle and the absence of spotting is a favorable sign in terms of prognosis.

If bleeding continues, the uterus contracts poorly, increases or remains at the same level of chorionic gonadotropin, this indicates a malignant course of the disease. In this case, it shows:

  • weekly monitoring of hCG levels until negative results are obtained;
  • after that, hCG is examined every month for two years;
  • Pelvic ultrasound every 14 days until recovery, then quarterly for 12 months;
  • x-ray of the lungs, if hCG does not decrease (exclusion of metastases);
  • hormonal contraception for 2 years.

The second stage is chemotherapy. Indications for her:

  • an increase in the titer of hCG or its stabilization;
  • destructive hydatidiform mole after surgery;
  • detection of metastases after removal of the hydatidiform mole.

Of the chemotherapy drugs, preference is given to dactinomycin. Perhaps the use of methotrexate. After the end of chemotherapy, you can become pregnant no earlier than 12 to 24 months in order to exclude chromosomal mutations and fetal malformations.

Vesical mole during pregnancy. This is a rare complication, but it can lead to fetal death and a threat to the health of the mother.

And now let's dwell on this in more detail.

What is a "bubbly drift"?

Bubble skid is a deviation in the development of the fetal egg. If this pathology occurs, the formation of the placenta does not occur. Chorionic villi are reborn into blisters, inside of which there is a liquid. It has a yellowish color and consists of:

  • amino acids;
  • chorionic gonadotropin;
  • albumin.

The diameter of the bubbles does not exceed 25 ml. Vesicular mole occurs in 0.02-0.8% of pregnancies. There are several varieties of the disease, the list of which includes:

  1. Complete or simple hydatidiform mole. The disease is characterized by pathological changes throughout the chorion.
  2. Partial hydatidiform mole. Pathological changes affect the chorion only partially.
  3. Destructive hydatidiform mole. This is the most severe form of the disease. She is malignant.

The first type of pathology appears in a woman during. In the presence of this form of the disease, the fetus dies, and then resolves.

Partial hydatidiform mole may appear after. In this situation, the pregnancy is not terminated. There is a possibility that it will end with the birth of a living child. In most cases, childbirth occurs prematurely. However, the child may appear on time. If the pathology appeared during a multiple pregnancy, it can affect only one placenta or both of them.

What does a bubble drift look like with a photo

If a woman develops a mole, the villi of the outer germinal membrane turn into cysts. This is the name given to the bubbles containing liquid. In addition, the growth of the epithelium of the villi is observed. Pathology can lead to the death of the fetus. To better understand what a cystic skid looks like, it is recommended that you familiarize yourself with the photo.

If the pathology has developed in the first 1-2 weeks of pregnancy, all the primary villi of the fetal egg are reborn. In the layers of trophoblasts there is pronounced hyperplasia. In this situation, we are talking about the appearance of 1 form of pathology. Sometimes a type of disease is called early hydatidiform mole. This is due to the timing of the onset of pathology. During this period of pregnancy, cystic drift is characterized by:

  • proliferation of trophoblasts lining the villi from the inside;
  • there is swelling of the villi and their increase;
  • the epithelium of the villi is not defined or undergoes dystrophic changes;
  • there are no blood vessels in the villi;
  • the embryo is resorbed.

If the pathology developed in the period from 3 months to 34 weeks inclusive, usually only a part of the chorionic villi is reborn. In this case, we are talking about the so-called incomplete hydatidiform mole. In this case, the villi that have not been reborn have a normal appearance. Their blood supply is preserved. In this case, the fetus in the uterus is observed. However, pathology can lead to his death.

In the case of multiple pregnancies, the problem may affect only one placenta. At the same time, 2 is able to remain in its normal form and continue to function.

Invasive hydatidiform mole can occur against the background of a complete or partial variety of pathology. Varieties of the disease are characterized by the following symptoms:

  • vesicles can grow into the muscular layers of the uterus;
  • villi can penetrate the blood vessels and lymphatic network, grow through the serous cover of the uterus and myometrium, spread throughout the body, and also affect internal organs;
  • the placental structure of the villi is preserved.

The destructive form of the disease is the most severe. It occurs in 5-6% of cases.

The first signs of hydatidiform mole

If a woman has developed a cystic skid, one of the signs of the disease is early toxicosis. It can be accompanied by an increase in temperature, as well as moisture in the skin. The patient is often nauseous. Against the background of nausea occurs. It appears due to severe violations of the water and electrolyte balance.

An alarming sign is the appearance of bloody discharge. They occur as a result of uterine bleeding. Bloody discharge can occur early in pregnancy and continue until childbirth or surgery to remove an egg. The secretions are dark in color and liquid thick. They are not abundant, but appear regularly.

Another sign is the abnormal size of the uterus. So, a three-month period in size can correspond to 5 months.

Symptoms signs of hydatidiform mole

The symptoms of a mole may vary from woman to woman. The fact is that pathology can form at different periods of bearing a child. The forms of the disease also differ. All this affects the clinical picture of pathology.

Usually a woman who has a problem begins to worry about uterine bleeding. The discharge is dark in color. Bleeding ranges from light to heavy. There are symptoms of toxicosis. Women often mistake them for signs of pregnancy. The patient is often worried about nausea and. She may experience increased salivation and dizziness. There is no appetite. Against this background, exhaustion may occur.

In severe cases, the cystic drift can grow into the walls of the uterus. This leads to a violation of its integrity, which in turn provokes the occurrence of intra-abdominal bleeding. Symptoms require immediate hospitalization and adequate therapy. Otherwise, there is a possibility of death.

The visual size of the uterus does not correspond to the gestational age. This can be confirmed by visual inspection and ultrasound. In a woman suffering from pathology, bilateral liquid ovarian cysts are detected. Their size can reach 10 cm or more. Cysts are easily detected during ultrasound. However, this symptom does not appear in all women who are faced with a hydatidiform mole. Treatment in this situation is not carried out. They will disappear on their own after the uterine cavity is cleared of hydatidiform mole.

In pathology, it is several times higher than the norm. During treatment, the doctor will necessarily check this indicator until it returns to normal. Even when the level returns to normal, a woman will still have to take this test regularly for six months. The action is carried out with a preventive purpose. Mole symptoms can appear early in pregnancy and mimic pregnancy symptoms. Therefore, diagnosing the problem during this period is quite problematic.

If the disease has become malignant, the vesicles can spread to other organs, mainly to the lungs. The prognosis in this case is unfavorable. Quite often there is a lethal outcome. For this reason, it is important to detect the pathology as early as possible and start its treatment. This will allow you to count on the fact that the process will regress irrevocably, and the woman's health will suffer minimally. There are other complications of diseases, the list of which includes:

  • the occurrence of infertility;
  • the appearance of an intrauterine infection;
  • septicemia;
  • the occurrence of thrombosis;

Causes and prevention signs of hydatidiform mole

Separately, there are categories of women who are at risk of developing the disease more than others. The risk group includes girls who are not yet ripe for pregnancy. The problem may arise if conception occurred at the age of 14-15 years. The risk of pathology is also present if a woman is older than 40 years. Other reasons that increase the likelihood of hydatidiform mole are:

  • the woman gave birth many times;
  • conception occurred between close relatives;
  • there is an immunodeficiency;
  • in the diet of a woman lacks some trace elements and vitamins.

The phenomenon is quite rare. On average, pathology is detected in 1 pregnant woman out of a thousand. However, the figure is quite relative.

As mentioned earlier, the exact causes of the disease have not been established. Therefore, there is no specific prevention of hydatidiform mole. However, experts have identified a number of measures that can reduce the risk of pathology. The list includes:

  • timely visit to the doctor on the fact of pregnancy. You need to register before 12 weeks;
  • a woman should completely stop taking drugs, alcohol, and smoking;
  • it is necessary to visit the obstetrician-gynecologist regularly. During the course, it should be shown to the doctor once a month. In the second trimester, the number of visits increases to 1 time in 2-3 weeks. In the third trimester, you need to go to a specialist once every 7-10 days;
  • pregnancy must be planned consciously. Preliminary it is recommended to pass all the necessary examinations;
  • within 3 months before the planned pregnancy and during the 1st trimester, it is recommended to take folic acid.

Treatment for signs of hydatidiform mole

Treatment of cystic drift during pregnancy depends on the individual characteristics of the course of the pathology, the period of bearing the child, as well as the type of disease. In some cases, the fetus can be saved. However, often the disease leads to a miscarriage or the need to remove the fetal egg. If an accurate diagnosis is made, it is not uncommon for a woman to be offered a minor operation. During it, curettage of the uterus is performed. The action is carried out in order to remove the remnants of pathological tissues. Then within 8 weeks after the operation it is necessary to observe stably. The woman will have to take regular tests and undergo an ultrasound every two weeks.

After the hydatidiform drift has been removed from the uterus with the help of surgery, the level in the blood is monitored. The value of the indicator should gradually decrease. This will be the main sign that the pathological processes in the uterus have stopped. Upon receipt of a negative value, the analysis is necessarily taken again. Actions are taken to make sure that the disease is actually cured. Additionally, a woman should be examined by a gynecologist-oncologist.

If an ultrasound shows that there is activity of a mole, and an X-ray examination of the lungs indicates a metastatic lesion, chemotherapy is performed. After it is possible to achieve remission, and laboratory parameters return to normal, 2-3 additional courses are carried out. The action is carried out for prevention.

A patient who is faced with a hydatidiform mole should be observed by an oncologist for another year. Blood levels are monitored monthly. During this period, planning a pregnancy is not recommended. The best means of protection against its onset are hormonal contraceptives. They allow you to normalize ovarian function after undergoing chemotherapy and getting rid of the disease. Treatment is applied until the moment when the menstrual cycle fully returns to normal.

If there is no need for chemotherapy, and the treatment was performed in other ways, doctors recommend refraining from pregnancy during the weather. Otherwise, the period is extended to 12 months. If conception occurs during this period, the level will definitely increase. This will lead to the fact that doctors will not be able to reliably determine the cause of the incident. It should be borne in mind that the cystic skid is able to recur. The probability of this is 1-2%. However, the recurrence of the pathology is still possible. In the vast majority of cases, pathology does not affect the possibility of having a child in the future. A mother who has had a disease can give birth to a healthy child. The chance of preterm birth also does not increase.

A hydatidiform mole (molar pregnancy) is a rare pregnancy complication that occurs in approximately one woman in a thousand. It occurs when the villi of the chorion - the membrane that surrounds the fetus and attaches it to the wall of the uterus - degenerate into bubble 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.

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

What happens during a hydatidiform mole?

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

  1. The spermatozoon fertilizes the egg, which 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 hydatidiform drift is called complete.
  2. Two sperm 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. The chorionic villi also develop abnormally and form vesicles. This pathology is called incomplete hydatidiform mole.

Causes of hydatidiform mole

The causes of hydatidiform drift have not been established at present. But there are factors that increase the risk of its development:

  • Age: Full hydatidiform mole occurs in adolescence and in those over 45 years of age. The number of previous pregnancies does not matter. A significant relationship between incomplete drift and age has not been established;
  • history of molar pregnancy - if a woman has had such a pathology before, the chances of re-development are regarded as 1-2% (without such experience 0.6%). Two or more hydatidiform drifts increase this figure to 15-20%;
  • ethnicity: this 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 (at the 10-14th week of pregnancy).

If there are signs of violations, then they usually occur between the 4th and 12th weeks. The most common symptom is uterine bleeding, a brown-reddish discharge from the vagina, in which altered chorionic villi, resembling a bunch of grapes, are sometimes visible. These are serious symptoms that require immediate medical attention. The standard diagnosis of the causes of bleeding includes ultrasound, during which a picture characteristic of a cystic mole is detected.

Many women who are subsequently diagnosed with a molar pregnancy report weakness and nausea in the first semester, usually more intense than with normal childbearing.

If a miscarriage occurs, the tissues of the fetus must be sent for examination in order to exclude a hydatidiform mole.

A medical examination may reveal other signs of hydatidiform mole:

  • the uterus is larger than is typical for the current period;
  • 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 good to prepare answers to some questions in advance:

  • date of last menstruation?
  • when were the symptoms first noticed?
  • Is the discomfort permanent or does it happen 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?
  • Are you worried about dizziness?
  • Has a hydatidiform mole been previously diagnosed?
  • what are the chronic diseases?
  • are you going to get pregnant in the future?

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

Treatment of hydatidiform mole

Bubble drift cannot end in the birth of a child (the exception is 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 along with the discharge. If this does not happen, they are removed surgically. Usually under general anesthesia. The standard procedure is called dilation and curettage of the uterus. During it, the doctor, using a gynecological speculum, gains access to the cervix, opens it and removes the contents of the organ cavity with a vacuum apparatus.

It is difficult to get rid of absolutely all pathological cells. Fortunately, after surgery, in 90% of women, they 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 (CG). 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 conception for six months to a year in order to avoid misinterpretation of the results, and in case of incomplete removal of abnormal chorion tissues, the development of a second molar pregnancy.

Women who no longer plan to have children may have their uterus removed (hysterectomy).

Folk treatment of hydatidiform mole

There are many "grandmother's" recipes on the Web that supposedly help cure molar pregnancy. But none of them has proven effectiveness. The time spent on ineffective procedures may 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 hydatidiform mole). The worst option is the transformation of the tumor into a malignant choriocarcinoma. Cancer cells penetrate the tissues of the uterus, sometimes growing through it and causing internal bleeding. When germinating 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 are detected in time. Relapse after treatment occurs in approximately 1-3% of women. It is imperative to control the level of hCG, since this indicator helps to notice the recurrence of the disease in time and start a course of chemotherapy in a timely manner.

Forecast

Complete cure is possible in most cases. Only 1% of women in the future may re-disease. After a second molar pregnancy, the risk of developing a third one 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 monitoring the level of hCG is completed. In the future, a woman has a good chance to conceive, endure and give birth to a healthy child. The doctor leading the pregnancy must be aware of previous cystic drifts, as well as other features of previous pregnancies. Since once-diagnosed women are at a slightly higher risk of developing it, they may be advised to have their first ultrasound earlier than with a standard screening schedule.

Pregnancy is a process not invented by doctors or scientists. The mystery of the birth of life was created by nature. Nature also brought into balance the birth of healthy children and the non-birth of sick and unviable children. This balance is achieved by the appearance of fetal pathologies even at the earliest stages. These include cystic drift.

Bubble skid and its types

Cystic skid (PM) is the most severe type of trophoblast pathology. The trophoblast allows the embryo to find an attachment site in the uterine wall. Further, the placenta is transformed from it. In PZ, the trophoblast transforms into small vesicles that accumulate in batches in the uterine cavity. They spread rapidly throughout the body and may metastasize to the lungs, as abnormalities in trophoblast development suggest tumors or near-tumor conditions.
With cystic drift, the uterine cavity filled with bubbles is clearly visible on ultrasound

PZ cells produce chorionic gonadotropin (hCG), which, during a normal pregnancy, produces an embryo. During a mole, the level of hCG in the blood is an order of magnitude higher than during a normal pregnancy. And even after the elimination of the PZ by scraping, hCG remains elevated for a long time, therefore it requires control. The embryo in this situation dies immediately.

Statistics show the infrequent occurrence of this pathology among pregnant women - 1 case per 1 thousand births.

Cystic drift can be simple and invasive (destructive).

  • a simple form of PZ is divided into full and partial. Complete PZ is a pathological change in the entire chorion and is detected in the first or second trimester of pregnancy. Partial PZ affects part of the chorion and is diagnosed in the second - third trimester (9-34 weeks of pregnancy).
  • invasive or destructive form of PZ is the most dangerous. In this case, chorionic villi, which during normal pregnancy contain many blood vessels, provide nourishment to the fetus, penetrate into the wall of the uterus, thin it and cause seeding with atypical cells, which can spread to neighboring organs.

Video: full hydatidiform skid

Characteristics of the types of cystic drift

A complete hydatidiform mole contains chromosomes 46 XX or 46 XY (diploid set), with all paternal chromosomes. In this case, the embryo is not visualized at all on ultrasound, only the vesicles and villi of the chorion are visible. Due to the rapidly increasing number of bubbles, the size of the uterus is also rapidly growing, while exceeding the size of the uterus at the corresponding gestational age. Complete hydatidiform drift is determined at 11–25 weeks of gestation. Unfortunately, 20% of cases of complete PT lead to the development of trophoblastic tumors and metastasis.
With complete hydatidiform mole, there are no reliable signs of pregnancy.

Partial PD is triploid, it has one maternal chromosome (69 XXX, 69 XXY, 69 XYU). At the same time, edematous villi of the chorion, some fragments of the embryo and placenta are visible. The size of the uterus is less than the corresponding gestational age or slightly larger. About 5% of cases lead to malignant transformation.
Part of the embryo may be preserved. The embryo dies immediately

Destructive PZ is the ingrowth of chorionic villi into the wall of the uterus, causing severe intraperitoneal bleeding. Mass destruction of tissues occurs. It can also lead to uterine rupture. It occurs in 5% of women with partial mole and 15% with complete mole.

Trophoblast tumors, not having their own vessels, destroy maternal blood vessels

Reasons for the development of hydatidiform mole

The reasons for the development of hydatidiform mole are not fully understood. The main one is chromosomal abnormalities. They can occur during the fertilization of an empty (non-nuclear) egg. In this case, the sperm chromosomes do not find additional genetic material from the egg, and the paternal chromosomes are duplicated and the maternal ones are lost. There have been cases of PZ when the egg was fertilized by two sperm.

Presumable causes are viral and infectious diseases of a woman (for example, toxoplasmosis), as well as hormonal disorders in the form of estrogen deficiency. These factors can contribute to the degeneration of the chorionic villi.

Develops more often PZ with repeated births. It can happen both in very young girls and in women after 35–40 years. Sometimes it manifests itself as a complication after an ectopic pregnancy. In this case, the localization of the PZ occurs in the fallopian tube.

The likelihood of hydatidiform mole is much higher with repeated termination of pregnancy, with closely related marriages, and the occurrence of immunodeficiency.

Recurring hydatidiform drift threatens infertility.

Cases are described when cystic drift is combined with a normally developing fetus. It is believed that this can occur during dizygotic pregnancy, when one fetal egg develops from a normal egg, and the second is presented as a complete mole.
The pattern of development of hydatidiform mole is still a topic of research.

Symptoms

  • uterine bleeding. As a rule, they are not abundant and are accompanied by a single release of bubbles. In the most difficult variant of PZ, profuse peritoneal bleeding may occur. Due to their frequent repetition, anemia and deterioration of the woman's condition can be provoked.
  • an increase in the size of the uterus. When examined by a gynecologist, a discrepancy between the gestational age and the size of the uterus will often be revealed. Moreover, this discrepancy is about 4 weeks. With a period of 4 weeks, the uterus will correspond to 12 weeks. This is due to the rapid increase in the number of bubbles in the uterine cavity.
  • deterioration in general condition. There is toxicosis, increased blood pressure, nausea, weakness, swelling.
  • an increase in the level of hCG in the blood. The indicator is several times higher than the norms existing at this stage of pregnancy. For a long time after the PZ, the level of hCG will remain elevated.
  • no signs of fetal life. Since PZ is associated with the death of the fetus, neither during palpation nor on ultrasound, its movements are observed, there is no heartbeat.
  • the formation of numerous cysts. This symptom is not found in all cases of PZ and is eliminated independently with the normalization of the woman's condition.

With all this, pregnancy tests will give a positive result, because they react to the presence of hCG in the urine of a woman.

If you observe any of the listed symptoms, you should not try to diagnose yourself. Seek immediate medical attention. And remember that often a timely visit to the doctor allows you to avoid the negative consequences of the disease.


 If you notice a discrepancy and a sharp jump in hCG levels in a blood test, seek an explanatory consultation with a doctor

Diagnosis of hydatidiform mole

Diagnosis of PZ is quite simple with the help of ultrasound. The doctor will confirm an increase in the uterus, the presence of bubble tissue (there is a term "blizzard" for a large number of bubbles), the absence of a fetus, the presence of ovarian cysts.

On examination, there will be bubbles in the discharge and a discrepancy with the term of the expected pregnancy.

Without fail, a woman repeatedly donates blood to the level of hCG. Usually the level of hCG is spasmodic. A blood test shows changes in the leukocyte formula and an increase in leukocytes. Urine may contain protein.

The doctor prescribes a hysteroscopy, or the uterine cavity is cleaned using vacuum aspiration. If necessary, a diagnostic laparoscopy can be performed.

After a histological examination of the material removed during the operation and confirmation of the diagnosis, the woman is sent to the oncology dispensary for observation. Within 8 weeks after the operation, doctors monitor the level of hCG in the blood, do an ultrasound. To exclude metastasis, x-rays of the lungs, MRI or CT of the brain, and ultrasound of the abdominal cavity are prescribed. In the absence of metastases and a normal level of hCG, chemotherapy is not performed.
Contact your gynecologist as soon as possible if you feel unwell and have bleeding from the genital tract

Treatment

There is no time for reflection when making such a diagnosis. If PZ is suspected, the woman is urgently hospitalized. The main goal is to cleanse the uterine cavity from bubbles. Vacuum aspiration or hysteroscopy is performed.

Sometimes the cystic skid comes out spontaneously.

After removal of the PZ, antibiotic therapy is prescribed. Without fail, a woman receives oxytocin for the speedy contraction of the uterus and bringing it to normal size.

In the presence of heavy bleeding or the presence of oncology, a hysterectomy can be performed - removal of the uterus, the appendages are left. In this case, hormone therapy is selected that matches the diagnosis.

For about a year and a half, the woman has been registered with a gynecologist - an oncologist. She should periodically donate blood for hCG, as well as undergo an ultrasound of the uterine cavity. The doctor prescribes treatment with oral contraceptives to restore hormonal levels and improve the menstrual cycle. It is recommended to abstain from pregnancy during this time. The body needs to recover.

Monitoring and examination by a mammologist is also mandatory. Changes in the hormonal background can affect the condition of the mammary glands.

Complications and possible consequences

If 8 weeks have passed after surgery and removal of the hydatidiform mole from the uterine cavity, and the hCG levels remain high, the woman is prescribed a deeper examination. Ultrasonography can confirm the presence of a trophoblastic tumor of choriocarcinoma. Her cells continue to actively divide and secrete hCG into the blood. The danger of this tumor is that the cells spread to other nearby organs - the lungs, liver, brain. Lung metastasis is common. In this case, the woman is prescribed chemotherapy. It is carried out by combining drugs that will get rid of the foci of PZ in the uterus and lungs, reduce the level of hCG to normal, and restore the menstrual cycle.

Fibrotic changes in the connective tissue can persist at the site of pathological foci for a very long time even after complete recovery.

Another 2-3 courses of chemotherapy are prescribed even in a state of remission, when the tests do not raise questions and the general condition of the patient is satisfactory. This is done for a preventive purpose. It is not worth neglecting such treatment, since choriocarcinoma can even lead to death, since the likelihood of metastasis is high.

As an outpatient treatment, oral contraceptives are prescribed. They will control the work of the ovaries after the disease and chemotherapy. It is recommended to exclude pregnancy during the entire recovery period.

Often, after suffering a hydatidiform mole, intrauterine infections form in the body, which, leading about 30% of women to infertility, 14% acquire a diagnosis of amenorrhea.
Do not refuse the proposed inpatient treatment, let the doctors help the body recover from a mole

Re-pregnancy after hydatidiform mole, preventive measures

Any pregnancy must be planned. Pregnancy after hydatidiform drift even more so. The probability of occurrence of cystic drift re-exists and is 1–2%. Therefore, it is better to endure the recovery period to the end and exclude pregnancy for 6–12 months. In the case of chemotherapy - from 12 months or more.

In the event of an unplanned pregnancy before the end of the agreed period, it is worth more carefully than during a normal pregnancy to monitor the condition of the woman. After all, in the presence of pregnancy, the level of hCG will rise, but the risk of developing repeated cystic drift will also give the presence of hCG in the blood. Up to 12 weeks, a woman undergoes several ultrasounds to make sure that the fetus is developing safely.

According to the Russian Cancer Center named after N.N. Blokhin, almost 100% of women who had a hydatidiform drift were cured by the use of chemotherapy. 90% of them were able to fully restore the menstrual cycle and reproductive functions, 70% were able to become a mother with a normal pregnancy and successful delivery.

I would like to give a lot of advice to women in the application of preventive measures against hydatidiform mole. But those do not exist, since the true causes of this disease have not been fully studied and established.

  1. Get registered for pregnancy no later than 12 weeks to detect fetal pathologies in the early stages.
  2. Regular visits to the gynecologist before pregnancy and especially during it.
  3. Plan pregnancy and prepare for it in the form of passing the recommended tests and specialists.
  4. Take multivitamins.
  5. Lead a healthy lifestyle - give up smoking and alcohol.

With this picture of the disease, pregnancy consists only of vesicular postpartum tissue, so to speak, the abundance of a child's place and no one who would live in it. An unusually high concentration of HCG provokes frequent and intense vomiting.

In the old days, hydatidiform mole caused great fear; it often led to bleeding of the female body, since in this disease the placenta, like cancer cells, grows into the uterine tissue. Bubble drift can last up to 3-5 months and is subject to mandatory curettage. Today, ultrasound can detect hydatidiform mole at an early stage. A woman is injected with a prostaglandin in order to activate the expulsion, and then curettage (curettage) is performed.

The interpretation of the situation indicates an unwillingness to perceive reality as it is. There is nothing suitable for food. The fetus is simply not detected, because the fixed egg has serious chromosomal defects.

In some sense, the hydatidiform drift is close to an imaginary pregnancy, although in this case there is a real threat to the life of a woman. In the case of an imaginary pregnancy, sooner or later we will find spiritual energies that have been directed in the wrong direction, while with a bubble drift, the connection with the bodily world turns out to be deeper. Everything seems to be normal, but only the most important - the egg and the seed - are destroyed so much that the unkind fetus that has arisen from their combination eats away the tissue of the female body like cancer cells and thereby exposes the woman's life to a serious threat.

In a figurative sense, we can talk about dangerous creativity that ignores content and meaning and creates excesses if its attempts are not resolutely suppressed from the outside. This is a dangerous, risky self-blindness that needs to be ended as soon as possible.

Causes of hydatidiform mole

This happens when the small, finger-like growths that attach the placenta to the wall of the uterus (chorionic villi) do not develop properly. As a result, instead of a baby, a shapeless mass is formed in the uterus. This is a tumor of the placental tissue that occurs due to chromosomal abnormalities in a fertilized egg. Bubble drift is a relatively rare phenomenon.

Signs and symptoms hydatidiform mole

The main symptom is bleeding at the 12th week of pregnancy. Often, the size of the uterus is much larger than normal for a given gestational age. Severe nausea and other pregnancy problems are not uncommon. Diagnosis can be made by ultrasound.

Treatment hydatidiform mole

The hydatidiform mole is removed from the uterus using vacuum suction and curettage. An anesthetic is given, the cervix dilates, and the contents are carefully removed by suction.

After removal, the doctor will monitor the level of the pregnancy hormone for a long time. Sometimes the tumor can take on a malignant character, and the level of the hormone remains high or even increases after the removal of the tumor. Therefore, hormone levels should be checked regularly. If the abnormal cells become cancerous (malignant), chemotherapy will be needed. This is one of the biggest advances in cancer treatment - with the right chemotherapy, this type of cancer is usually curable.

Women who have a hydatidiform mole are advised not to become pregnant for at least a year. The risk of recurrence is quite high. However, the chances that the next pregnancy will be normal are also quite high.

Hydatid hydatidiform mole

Hydatid mole is caused by a chromosome abnormality that occurs during fertilization. It provokes the degeneration of the trophoblast (tissue of placental origin), which is the cause of the tumor, in most cases benign. Pregnancy (then referred to as pregnancy with a hydatid drift) cannot continue, as this hydatid drift interferes with the development of the embryo and fetal bladder.

The rate of pregnancy with hydatidiform mole varies greatly by region, with about 1 in 2000 in Europe and 1 in 85 in Asia. Such an anomaly most often depends on age: a very young or elderly mother.

Symptoms. Most often this is bleeding (metrorrhagia) and severe and untreated vomiting. During a physical examination, it is found that the uterus is soft and larger than it should be at this time. When measuring the level of pregnancy hormone, it turns out that it is incredibly high. The diagnosis is confirmed by ultrasound, which proves a mole.

Treatment. The contents of the uterus are scraped out, and then the recovery is monitored by measuring the level of pregnancy hormone in the blood.
Laboratory analysis of the extracted matter is performed to determine the nature of the tumor. If it is malignant (choriocarcinoma) or in the case of persistent hydatidiform mole, chemotherapy is needed.

Risk of relapse. After a mole, a normal pregnancy is possible. However, a woman who had this ailment should be monitored for at least a year to prevent a possible relapse. Any new pregnancy is contraindicated during this period so as not to interfere with observation.