Youth and beauty 

Vesiculate skid treatment after curettage. Bubble drift - what is it? Why does cystic drift develop?

How often women look forward to those cherished two stripes on the dough that will turn their lives upside down! But, unfortunately, the joy of getting pregnant does not always last as long as we would like. Exists great amount pathologies, as a result of which this process must be interrupted. Many people know about miscarriage. But besides them, there is another deviation, as a result of which a woman cannot enjoy motherhood. This is the so-called bubble drift. So, what is this pathology and why does it arise? Let's analyze this question in more detail.

What happens when you get sick?

Bubble drift- This is a chorionic disease, during which the transformation of its villi into formations from bubbles occurs, the size of which can reach the size of a large grape berry and even more. They are connected with each other by gray tree-like trunks containing a clear liquid with albumin or mucin.

According to statistics, cystic drift occurs in one out of a hundred pregnant women. The outcome of the disease is almost always the same - either spontaneous death of the fetus with its subsequent expulsion from the uterine cavity, or artificial termination of pregnancy. The birth of a child, especially a healthy one, with this pathology is possible, but it is rather an exception to the rule, which has 1 chance in a million.

Causes of the disease

The exact factor that provokes the development of the disease has not yet been identified. It used to be thought that gallbladder drift during pregnancy is the result of pathologies such as syphilis, anemia, chlorosis, nephritis, and so on. But in recent times the opinion of doctors has changed significantly. The specialists were divided into two camps.

The first assure that the cystic drift occurs as a result of inflammation of the uterine wall, and the process of degeneration of the chorionic villi into vesicles is already a secondary phenomenon. This theory even has scientific evidence... For example, in a woman who becomes pregnant from different men, this pathology occurs during each conception. At the same time, scientists have assumptions that not the entire mucous membrane of the uterus may be affected, but only part of it. To prove this conjecture, an example is given, when during a two-egg pregnancy, only one ovum was reborn, while the other remained healthy and did not undergo a disease.

The second camp of doctors and scientists believes that the causes of pathology are the following: a primary disease of the egg, which occurs even at the stage of its presence in the ovary, and secondary disorders of its development already beyond the ovum. At the same time, confirmation of their theory is that during the illness, there are very often cases when a fine-grained degeneration of both ovaries occurs. Then such formations will be defined as a sausage or spherical tumor with a bumpy surface.

Another reason that can cause cystic drift disease is the presence in the fetus of a set of father's chromosomes, while from the mother they are insufficient or absent altogether. Such a pathology occurs when there is a simultaneous fertilization of one egg by two spermatozoa.

Several types of disease

A simple hydatidiform mole appears in the first three months of pregnancy. The reason for the development of the deviation is the presence of only paternal chromosomes in the fertilized egg. At the same time, maternal ones are completely absent. Duplication of the paternal chromosomes leads to the fact that the formation of the embryo does not occur, there is no placenta and no fertilized bladder. It is possible to identify a complete cystic drift using an ultrasound method. During the procedure, it will be seen that the size of the uterus differs significantly from the expected gestational age (they are enlarged). The formation of a malignant tumor and the appearance of metastases can also be observed.

Partial cystic motility is characterized by the presence of one set of maternal chromosomes and two paternal chromosomes in a fertilized egg. Such situations occur in cases where one egg is inseminated by two sperm. It can also happen when paternal chromosomes are duplicated. This type of cystic mole develops after 12 weeks of pregnancy. In this case, the formation of the placental structure of a cystic nature and placental tissue occurs.

There is also an invasive form of the disease, in which the villi grow deep into the myometrium, destroying all tissues. This pathology may be accompanied by the appearance of bleeding.

disease development

Most often, cystic drift occurs when:

  • repeated pregnancies;
  • the presence of many abortions;
  • immunodeficiency;
  • ectopic pregnancy;
  • lack of vitamin A and animal fats in food;
  • thyrotoxicosis (disease thyroid gland);
  • early (before 18 years) or late pregnancy (after 40 years);
  • closely related intimate relationships.

Bubble drift: symptoms

The most obvious sign of the presence of the disease is the appearance of a dark red discharge from the genital tract with an admixture of rejected drift bubbles. They are not very abundant and irregular. But if this deviation is found, urgent hospitalization of the pregnant woman is required, since there is a risk of death. If in the thickness of the myometrium there was a deep growth of elements of the cystic drift, then intra-abdominal bleeding is possible.

The presence of pathologists may also be indicated by the absence of the simplest symptoms of pregnancy: which cannot be heard even with the help of an ultrasound scan, its movements, as well as probing parts of the child. With all this, the pregnancy test shows positive result, but the concentration of hCG exceeds due date the norm. In such a situation, bubble drift is quite obvious.

Signs that may also indicate pathology:

  • toxicosis, accompanied by vomiting;
  • an increase in liver failure;
  • profuse salivation;
  • weight loss;
  • symptoms of eclamasia and preeclampsia in the first trimester;
  • protein in the urine;
  • swelling;
  • stomach ache;
  • headache;
  • increased blood pressure;
  • weakness.

Also, gallbladder, the symptoms of which, as already mentioned, can appear in both the first and second semester, is characterized by an active increase in the size of the uterus. As a rule, they significantly exceed the norm for the established period.

Bubble drift: consequences

The main complication of the disease is the development of chorionic carcinoma. It is a malignant form, which is characterized by the invasion of abnormal tissues into the uterus, liver, lungs and brain. And this is already leading to death.

There are several stages of gestational tumors:

  • the gallbladder itself, characterized by the presence of malignancy within the uterus;
  • the so-called bed of the placenta - the localization of the tumor in the muscles of the organ and in the placenta attachment;
  • non-metastatic tumor - germination of similar tissues of childbirth or cystic drift into the uterus;
  • metastatic tumors with a good prognosis - the malignant formation does not leave the uterine cavity (a positive outcome of the disease is possible if last pregnancy was less than 4 months ago, there are no metastases in the brain and liver, the patient did not have chemotherapy, the level of beta-hCG does not exceed the norm);
  • metastatic tumors with bad prognosis- cancer spreads outside the uterus to other organs.

In addition to this pathology, cystic drift has several more negative consequences. For example:


Diagnosis of the disease. Methods

Detection of pathology on early stages it is almost impossible without an ultrasound scan. After all, the appearance of nausea, fatigue and many other signs of an ailment is also characteristic of a normally proceeding pregnancy. As a rule, a woman learns about a cystic drift either during a planned ultrasound procedure, or only after the appearance of bleeding or the absence of fetal movement in due time.

Methods for diagnosing the disease:

  • gynecological examination, during which the doctor can feel the densely elastic consistency of the uterus and determine the increase in its size;
  • Ultrasound - shows the presence of ovarian cysts and homogeneous fine-grained tissue;
  • phonocardiography - listens to the heartbeat of the fetus, which is absent in case of a disease;
  • studies of chorionic gonadotropin (in rare cases, an analysis of the determination of a coagulogram and creatinine is carried out, and liver samples are also taken);
  • hysteroscopy;
  • biopsy;
  • diagnostic laparoscopy;
  • abdominal x-rays and chest, MRI of the brain - carried out to exclude the elimination of cystic drift;
  • laparoscopic echography.

Analyzes required to identify pathology:

  • blood biochemistry;
  • general urine and blood tests.

A patient who has been diagnosed with a disease needs to consult an oncologist, surgeon, endocrinologist and nephrologist.

Solution

After the diagnosis of "cystic drift", the treatment of which is aimed at removing the neoplasm from the uterine cavity, is confirmed, the woman is sent to a hospital. If the disease has no complications and the gestational age does not exceed 12 weeks, then a scraping procedure is performed. For this, the neck is stretched, which provides better access to its cavity, and with the help of a curette (a special instrument), all uterine contents are removed.

Vacuum aspiration is used even in cases where the uterus has a size corresponding to 20 weeks of pregnancy. Concludes this procedure in the suction of the contents of the cavity using special equipment. Often it is performed together with scraping.

With an increase in the volume of the uterus to a size that corresponds to 24 weeks of pregnancy, they also perform indications for the operation: thinning of its walls, perforation of the cystic drift and the presence of metastases in the lungs or vagina. In this case, the ovaries are not removed.

After removing the cystic drift from the uterine cavity, its tissues are sent for histological examination to exclude chorionepithelioma. If this procedure showed a malignancy of the formation, the level of hCG after a cystic drift tends to increase, and foci of metastatic origin are found in the lungs, then the patient is prescribed chemotherapy.

For the treatment of pathology, the means "Methotrexate" and "Dactinomycin" are used, or a drug that combines these two drugs - "Leucovorin". The main course of action of these medicines is to destroy cancer cells. Reception of these drugs is prescribed until the level of hCG and the menstrual cycle is normalized, pathological foci in the lungs and uterus disappear. After getting rid of these symptoms, the patient is prescribed several more preventive chemotherapy courses with the same drugs.

In some cases, it may be necessary to carry out radiation therapy in the form of X-rays and other types of radiation. It is carried out both outside, with the help of apparatus, and from the inside. In the latter case, the so-called radioisotopes are used, which produce radiation to the area where the malignant cells are located, using thin plastic tubes.

Follow-up of the patient after treatment

For about two years after the operation, the woman is under careful control oncologist. At this time, she undergoes the following procedures:

  • Control over hCG level every week for 1-2 months until the result is negative 3 times in a row. After that, this analysis is carried out, but much less often.
  • performed once a month until the hCG level is normalized.
  • 14 days after the operation to remove the cystic drift, an ultrasound of the pelvic organs is done. Then the procedure is performed every month until negative hCG levels.

Is pregnancy possible after an illness?

Bladder motility, the consequences of which can be very dire, is not a disease that leads to complete infertility. But it should be borne in mind that during the entire time of observation of the patient with an oncologist, she is not recommended to become pregnant. The main method of contraception at this time is taking hormonal drugs... This is due to them positive impact on the regulation of ovarian function, impaired as a result of the disease.

It is necessary to plan the next pregnancy no earlier than 2 years after the operation. This is especially true if the patient underwent chemotherapy. After the onset of conception, a woman should be closely monitored by medical personnel, since the likelihood of complications in the course of pregnancy and childbirth is high.

A patient who has suffered a cystic drift and wants to get pregnant again should not set herself up for a worse outcome and the inability to have children. Thanks to modern medicine, almost 70% of women experience the joy of motherhood after overcoming this disease.

Can the disease return?

As a rule, a relapse of the disease manifests itself in the form malignant formation in the pancreas, lungs and other organs and tissues.

Bubble drift- this is rare pathology pregnancy associated with 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 in the uterus instead of normal placenta unusual tissue, consisting of cluster-like clusters of bubbles 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 fluid that secretes hCG chorionic gonadotropin(pregnancy hormone), therefore, 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. Physical 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 enters special group 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 a large number 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 form of cystic drift, the fetus dies, and the 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 it, although it 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.

On initial dates cystic motility 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 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;

- absence fetal egg early and fetal later dates, with a partial drift, 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 during 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 an important indicator in the diagnosis. 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. V a similar situation 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, therapeutic tactics are changing: 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. High probability dangerous bleeding and rupture of the uterus are the basis for the use of 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, therefore, we can say 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 those with infectious diseases and hormonal dysfunction patients, it is necessary to eliminate the source of the infection and restore the 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 helps Attentive attitude patients for pregnancy and the implementation of all recommendations given by the doctor.

Bubble drift during pregnancy is one of the rarest complications in the process of carrying a child. Such a deviation occurs due to violations of the fertilization process, which causes wrong development cells that form the placenta.

With a cystic drift, a specialist Veronica
risk of pathology pregnant accuracy
the contraction doctor has clothes


Vesicular motility refers to diseases that have the general name "trophoblastic tumors". They are usually non-cancerous. Although they are likely to spread outside the uterus, tumors are treatable.

Stages and signs of the disease

Bubble drift during pregnancy has several varieties, shown in the photo:

  • complete cystic drift (normal) - represents pathological changes in the entire chorion;
  • partial cystic drift - changes cover only some part of the chorion;
  • destroying cystic drift - modified villi penetrate the walls of the uterus. This is the most severe form this disease, since it can lead to the development of dangerous intra-abdominal and external bleeding, and the tumor becomes malignant.

Loss of maternal genes and duplication of paternal chromosomes occurs

Full bladder drift is characterized by the development at the beginning of " interesting situation", during three months. Normal conception implies the presence of 23 paternal and 23 maternal chromosomes in the egg. If a complete cystic drift is observed, the fertilized egg contains only the paternal chromosomes, and does not have the maternal ones. Since there is a duplication of the paternal chromosomes, the egg cell includes 2 sets of them. As a result, the formation of the embryo does not occur, and the natural placental tissue and the fertilized bladder is absent.

Partial hydatidiform mole implies triplody; in other words, cells contain 69 chromosomes. The additional set is characterized by paternal origin.

The fetus with this form of pathology also has signs of triplodia: intrauterine retention, as well as various developmental abnormalities, for example, hydrocephalus and syndactyly.

Incomplete hydatidiform mole occurs when a fertilized egg has 23 maternal chromosomes and a double set of paternal chromosomes. This pathology happens when two sperm cells fertilize an egg at once. For this reason, natural placental tissue and cystic placental structure are formed. After appointment correct treatment and constant medical supervision, the development of any abnormalities associated with trophoblastic disease is unlikely.

They are characteristic signs of pathology.

  1. Bleeding caused by detachment of the placenta from the decidua.
  2. An enlarged uterus caused by accumulation of blood and chorionic growth.
  3. Preeclampsia (sometimes eclampsia), which is accompanied by an increase in the size of the uterus.
  4. HCG with cystic drift has a very high level.
  5. Vomiting in women carrying a child, which is caused by complex imbalances in water and electrolyte balance.
  6. Embolism of parts of the pulmonary artery.
  7. Very rarely - thyrotoxicosis, which is accompanied by tremor, tachycardia, high temperature body and skin moisture.
  8. Tecaluteal ovarian cyst caused by high level hormones that stimulate the ovaries, and disappear on their own after a few months.

Diagnosis of complications in a woman

During the diagnosis, first of all, the doctor takes into account the complaints future mother... For example, the following can indirectly indicate the presence of pathology:

  • bleeding;
  • discharge of purulent and serous leucorrhoea;
  • painful sensations in the abdomen, chest, lower back;
  • severe headache that leads to vomiting, visual impairment;
  • neurological signs.

Examination by a specialist is obligatory

Anamnesis analysis is equally important. The main pathologies that are characteristic of this disease are:

  • preeclampsia in the early stages of childbearing;
  • constant vomiting in the expectant mother;
  • thyrotoxicosis;
  • embolism of parts of the pulmonary artery.

Another diagnostic tool is ultrasound diagnostics. With such a disease, the following may be present:

  • increased size of the uterus;
  • lack of an embryo;
  • lack of heartbeat in the embryo;
  • lack of parts of the embryo;
  • the presence of a homogeneous small cystic substance;
  • the presence of a tetalutein ovarian cyst.

Other methods for diagnosing this disease include:

  • laboratory research ( general analysis blood);
  • biochemical studies (determination of the level of creatinine, study of kidney function, coagulogram);
  • examination by a gynecologist (examination of the hardness, shape, size of the uterus, vaginal mucosa);
  • hysteroscopy, laparoscopy;
  • chest x-ray;
  • determination of the karyotype;
  • CT scan;
  • Magnetic resonance imaging.

Basic therapy methods

Treatment of the disease can be carried out different methods... Some approaches are considered standard, some are undergoing research in clinical trials. Such research is needed to improve known methods therapy, as well as obtaining information about the effectiveness of new approaches. Also find out how and what is dangerous.

Consider the main methods of treating the disease shown in the photo.

Therapy methodDescription
SurgicalCurettage and dilation with gradual curettage is a stretching of the cervix in order to gain access and eliminate the entire contents of the uterus using special vacuum devices. The walls of the uterus are thoroughly scraped to be able to completely remove all contents. As a rule, all symptoms disappear after scraping.
Hysterectomy is complete removal uterus. With this disease, the ovaries are not touched.
ChemotherapyFor the implementation of chemotherapy for the treatment of complete skidding, agents are used whose main action is aimed at eliminating cancer cells... This method of treatment can be carried out both with the help of tablets, and intravenous or intramuscular administration of drugs. Chemotherapy is classified as a systemic treatment, since all drugs go through the same bloodstream and are carried throughout the body, destroying malignant cells in their path.
Radiation therapyRadiation therapy to remove tumor cells and reduce the size of the tumor involves the use of X-rays and other types of radiation. This method can be carried out using a special apparatus located externally (external therapy) or internally using materials that emit radiation through thin tubes directly to the location of malignant cells (internal therapy).

Traditional methods of treatment

Veronica officinalis is used in the treatment of this pathology.

Symptoms of pathology in the early stages of the "interesting situation" are aggravated by the fact that the tumor grows according to the laws of pregnancy, in other words, it increases every day. At the same time, the growth rate is much higher than during the normal course of pregnancy. That is why, when making decisions about self-treatment diseases, you risk your life.

It's another matter if you combine folk recipes with the means that the doctor has prescribed for you. This will help prevent side effects and new pregnancies.

Tincture of Veronica officinalis:

  • 2 tbsp. spoons of herbs;
  • 500 ml of water;
  • chop the grass;
  • to boil water;
  • close the lid;
  • insist 2 hours;
  • strain.

Application.

  1. Take 3 times / day, 150 ml.
  2. The duration of the course is 2 months.

Baths with lacfiol:

  • 4 tbsp. spoons of herbs;
  • 2 liters of water;
  • chop the grass;
  • to boil water;
  • pour boiling water over chopped grass;
  • Boil for 15 minutes;
  • strain;
  • cool to 40 C.

Application.

  1. Pour the prepared solution into a basin.
  2. Take a sitz bath for about 20 minutes.
  3. The duration of therapy is 1 week.

Carrots with cod liver:

  • 1 medium carrot;
  • 50 g cod liver;
  • finely grate carrots;
  • simmer for 5 minutes in a dry frying pan;
  • mix with ready-made cod liver.

Application.

  1. Eat this salad every day.
  2. Take a break for a week.
  3. Repeat 2 more courses.
  4. Carry out therapy 2 times / year.
Development hazards and prevention

One of the complications is increased risk childbirth pathology

The main complication of this disease is the development of chorionicarcinoma - it is a malignant disease, which implies the growth of pathological tissues into the uterus, lungs, liver and brain. This, in turn, can be fatal. The following stages of tumors are distinguished.

  1. Chorionepithelioma of the uterus or cystic drift, the main symptom of which is the presence of a neoplasm within the uterus.
  2. Placenta bed - the location of the tumor in the muscle of the organ, as well as the placenta attachment.
  3. Non-metastatic neoplasm - penetration of similar tissues into the uterus after childbirth, abortion.
  4. Metastatic neoplasm with a good prognosis - malignant tumor that does not leave the uterine cavity (positive dynamics is possible if the last pregnancy was less than 4 months ago, there are no metastases in the brain and liver).
  5. Metastatic tumor with a poor prognosis - the cancer has spread outside the uterus to other organs.

Other complications:

  • the impossibility of the onset of subsequent pregnancies (infertility) - such a consequence is observed in almost 30% of women who have had this disease;
  • amenorrhea - permanent or temporary absence of menstrual bleeding, this pathology is typical for 12% of women;
  • thrombosis;
  • septic diseases.

Among the methods of preventing this disease are:

  • preparation for pregnancy, passing all examinations and tests in advance;
  • to give up smoking, alcoholic beverages and drugs;
  • reception folic acid 3 months before the planned pregnancy, as well as within 1 month of the "interesting situation";
  • regular visits to the gynecologist;
  • timely registration in the antenatal clinic.

    • Attention!

    The information published on the site is for informational purposes only and is intended for information only. Site visitors should not use them as medical advice! The editors of the site do not advise to self-medicate. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your attending physician! Remember that only complete diagnostics and therapy under the supervision of a doctor will help to completely get rid of the disease!

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

Now let's dwell on this in more detail.

What is bubble drift?

Bubble drift is an abnormality in the development of the ovum. If this pathology has arisen, the formation of the placenta does not occur. Chorionic villi are reborn into bubbles, inside of which there is liquid. It is yellowish in color and consists of:

  • amino acids;
  • chorionic gonadotropin;
  • albumin.

The diameter of the bubbles does not exceed 25 ml. Bubble drift occurs in 0.02-0.8% of pregnancies. There are several types 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 cystic drift. This is the most severe form of the disease. It 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 dissolves.

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

What does a bubble skid look like from a photo?

If a woman develops a cystic drift, the villi of the outer embryonic membrane turn into cysts. This name was given to bubbles containing liquid. In addition, the proliferation of villous epithelium is observed. Pathology can lead to fetal death. To better understand what a bubble drift looks like, it is recommended that you familiarize yourself with the photo.

If the pathology develops in the first 1-2 weeks of pregnancy, all primary villi of the ovum are reborn. Severe hyperplasia is present in the layers of trophoblasts. In this situation, we are talking about the appearance of 1 form of pathology. Sometimes the type of disease is called early bladder drift. 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 villi epithelium is not defined or undergoes dystrophic changes;
  • there are no blood vessels in the villi;
  • the embryo is absorbed.

If the pathology developed between 3 months and up to 34 weeks inclusive, usually only part of the chorionic villi is reborn. In this case, we are talking about the so-called incomplete cystic drift. In this case, the villi that have not been reborn have a normal appearance. Their blood supply is maintained. In this case, the fetus is observed in the uterus. 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 cystic drift can occur against the background of a complete or partial type of pathology. Varieties of the disease are characterized by the following symptoms:

  • bubbles can grow into the muscle layers of the uterus;
  • villi can penetrate the blood vessels and the lymphatic network, grow through the serous membrane of the uterus and myometrium, spreading throughout the body, and also affect the 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 cystic drift

If a woman has developed a cystic drift, 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 arises. It appears due to severe violations of water and electrolyte balance.

The appearance of bloody discharge is an alarming sign. They result from uterine bleeding. Bloody issues can occur early in pregnancy and continue until childbirth or oocyte removal surgery. The discharge is dark in color and fluid. They are not abundant, but appear regularly.

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

Symptoms and signs of cystic skid

The symptoms of cystic drift may differ 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 is faced with a problem begins to be bothered uterine bleeding... Highlights are dark in color. Bleeding ranges from minor to profuse. Symptoms of toxicosis appear. Women often mistake them for signs of pregnancy. The patient is often worried about nausea and. She may have increased drooling and dizziness. No appetite. Against this background, exhaustion may occur.

In severe cases, 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. A woman suffering from pathology has bilateral fluid cysts of the ovaries. Their size can reach 10 cm or more. Cysts are easily detected during an ultrasound scan. However, this symptom is not manifested 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 cystic drift.

With 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 performed with preventive purpose... The symptoms of gallbladder drift can appear in the early stages of pregnancy and mimic its signs. Therefore, it is quite problematic to diagnose the problem during this period.

If the disease has developed into a malignant form, the bubbles are able to spread to other organs, mainly to the lungs. The prognosis in this case is unfavorable. Death often occurs. For this reason, it is important to detect the pathology as early as possible and begin its treatment. This will make it possible 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 of signs of cystic drift

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 can arise if conception occurred at the age of 14-15 years. The risk of pathology is also present if the woman is over 40 years old. Other reasons that increase the likelihood of cystic drift are:

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

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

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

  • timely access to a doctor after pregnancy. You must register before 12 weeks;
  • a woman must completely stop taking drugs, alcohol, and also smoking;
  • it is necessary to regularly visit an obstetrician-gynecologist. During 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. It is preliminarily 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.

Treating signs of cystic drift

Treatment for gallbladder during pregnancy depends on individual characteristics 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 its miscarriage or the need to remove the ovum. If an accurate diagnosis is made, a woman is often asked to undergo minor surgery. During it, curettage of the uterus is performed. The action is carried out in order to remove the remnants of pathological tissues. Then, for 8 weeks after the operation, it is necessary to be monitored stably. The woman will have to be tested regularly and undergo an ultrasound scan every two weeks.

After the cystic mole has been removed from the uterus with surgical intervention, the level in the blood is monitored. The value of the indicator should gradually fall. This will be the main sign that the pathological processes in the uterus have stopped. If a negative value is obtained, the analysis must be taken again without fail. Actions are performed in order to make sure that the disease is indeed healed. Additionally, a woman should be examined by a gynecologist-oncologist.

If an ultrasound scan shows that there is cystic drift activity, and an X-ray of the lungs indicates metastatic lesions, chemotherapy is given. After achieving remission, and laboratory parameters come back to normal, 2-3 additional courses are carried out. The action is performed for prevention.

A patient faced with a cystic drift should be observed by an oncologist for another year. Blood levels are monitored monthly. It is not recommended to plan a pregnancy during this period. The best means hormonal contraceptives act as protection against its onset. They allow you to normalize ovarian function after undergoing chemotherapy and getting rid of the disease. Treatment is applied until the menstrual cycle is completely back to normal.

If there is no need for chemotherapy, and the treatment was carried out 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 certainly 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 cystic drift can recur. The likelihood of this is 1-2%. However, the re-emergence of pathology is still possible. In the overwhelming majority of cases, pathology does not in any way affect the ability to have a child in the future. A mother who has had the disease can have a healthy baby. Chance for premature birth also does not rise.

Some women during pregnancy are faced with such a concept as cystic drift; the reasons, symptoms, methods of diagnosis and control will be discussed.

The concept of cystic drift and its development mechanism

Bubble drift (synonym - molar pregnancy) is a complication in which the chorionic membrane villi degenerate into vesicular structures with a benign (usually) course. In their structure, these bubbles resemble bunches of grapes, the size of which can vary from small to very large.

Grape-like cysts are filled with a light yellow liquid containing albumin, chorionic gonadotropin, globulins and various amino acids.

This pathological process is considered quite rare and occurs in about 1 woman in 1000.

Bubble drift during pregnancy can develop according to 2 different mechanisms:

  1. when fertilization of a nuclear-free female reproductive cell occurred, followed by the replacement of maternal chromosomes (which are not enough) with paternal ones. Chorionic villi are replaced by cysts. In this case, the formation of an embryo does not occur. This type is called complete, it is detected, as a rule, during the gestation period between 11 and 25 weeks;
  2. as a result of penetration of 2 spermatozoa into a functionally complete egg cell. Consequently, 3 sets of chromosomes are formed in the zygote. The death of the embryo is observed on early stages its development. By this mechanism, an incomplete drift occurs.

The reasons for the development of complications

Currently, there is more than one hypothesis for the occurrence of trophoblast pathologies.

Among the main ones, it is customary to distinguish:

  1. gestational chromosomal abnormalities: homogeneous disomy, triplodia, or a defect resulting from the fertilization of one functionally defective egg with 2 spermatozoa;
  2. exposure to an infectious agent: bacteria, viruses, protozoa;
  3. localization of the embryo in one of the fallopian tubes.

At the same time, there are a number of factors provoking this pathology. These include:

  • pregnancy in women under 18 and over 45;
  • history of spontaneous abortion;
  • history of trophoblastic diseases;
  • various immunodeficiency states;
  • multiple births;
  • thyrotoxicosis;
  • closely related marriages.

The reasons for the degeneration of trophoblast can be combined with each other, thereby increasing the likelihood of its occurrence in this and subsequent pregnancies.

Clinical picture







At the earliest stages of embryo development (up to 4-12 weeks), it is almost impossible to suspect pathology. At the same time, a rather vivid clinical picture may appear, on the basis of which, however, a final diagnosis cannot be made.

You can suspect the development of molar pregnancy when the following symptoms appear:

  • uterine bleeding, which is characterized by bright, saturated red-brown pathological discharge from the genital tract, sometimes upon closer examination of which, one can notice the chorionic villi, in shape resembling bunches of grapes. If we are talking about an invasive form, the development of massive intra-abdominal bleeding is possible;
  • enlarged, not corresponding to the gestational age, the size of the uterus as a result of the active growth of cysts;
  • lack of fetal heartbeat during ultrasound;
  • nonspecific signs that are similar to the manifestation of classical toxicosis, but many times stronger: nausea, vomiting, salivation, exhausting weakness, preeclampsia, as well as eclampsia (edema, elevated level protein in urine, arterial hypertension);
  • arterial hypertension;
  • anemia.

Due to the fact that the fetus dies at the early stages of formation and development, then with gynecological examination the doctor does not always manage to feel the ovum. In addition, an ultrasound photo may also not answer the question of a possible pregnancy.

Diagnostic algorithm

It is not possible to make the final correct final diagnosis based on the clinical picture due to its similarity with numerous gynecological pathologies.

Therefore, there is a clear algorithm that allows differential diagnosis between other pathologies.

To identify a complete or partial cystic drift, the causes of which are not exactly known, allow such research methods as:

  • gynecological examination in mirrors with bimanual examination of the pelvic organs. The doctor notes an increased size of the genital organ with an area of ​​softening;
  • determination of the level of hCG;
  • Ultrasound of the reproductive organs and abdominal cavity. An ultrasound examination of the uterus of the ovum is not visible, but cysts are clearly visible (sometimes of huge sizes - up to 15 cm) and small cystic tissue (a symptom of a "snow storm");
  • hysteroscopy;
  • ultrasound hysterosalpingoscopy;
  • laparoscopic echography;
  • in the presence of indications and difficulty in differential diagnosis - diagnostic laparoscopy;
  • CT and MRI are performed to exclude metastasis in abdominal cavity and chest.

Treatment

When diagnosed with painting pregnancy, a woman will not be able to bear and give birth to a baby. The exceptions are cases of bearing multiple fetuses when it comes to twins. Then one of the fruits develops fully, and the second dies.

Most often, pregnancy has to be interrupted, and the formed cysts are removed by surgery.

Surgical treatment is represented by dilation and curettage of the uterus. Removal of formations occurs under general anesthesia... It is almost impossible to eliminate the entire pathological focus, but in most cases the remaining cells die off by themselves. In order to speed up this process, medications such as Leucovorin, Methotrexate, Dactinomycin, etc. are prescribed. After removal, a part of the altered focus is sent to histology without fail.

The early postoperative period includes HCG control for six months. This examination is mandatory to detect possible relapse. After all, it is the chorionic gonadotropin that indicates the accomplished conception, and can be released due to the presence of residual not removed villi. Besides, in postoperative period shows the control of ultrasound of the pelvic organs and X-ray of the lungs.

“Those patients who Rh negative group blood in combination with a partial cystic drift should undergo a course of anti-rhesus immunoglobulin "- advises the Association of Oncologists of Russia.

Any patient treated regarding the degeneration of the chorionic membrane, must comply with the clinical recommendations of the Association of Oncologists of Russia, which include:

  • serum hCG study: weekly until 3 negative results are obtained sequentially, then once a month for six months, and then once every 60 days for 6 months;
  • radiography immediately after removal of the focus, then after 1 and 2 months;
  • UST half a month after removal of the cystic drift and then every month until the level of chorionic gonadotropin is completely normalized;
  • self-management of the menogram for at least 3 years.

Is pregnancy possible after cystic drift?

Many pregnant women, faced with a trophoblastic formation, and having insufficient knowledge, assume that it is cancer, and the only method of dealing with it is the complete removal of the genital organ with appendages.

Vesiculate mole, both complete and partial, is a neoplasia that can be benign or, conversely, malignant.

In fact, pregnancy after a skid is possible. But, when planning it, it should be remembered that the previously transferred pathology of trophoblast with very likely will make itself felt during next pregnancy and childbirth.

Conclusion

A qualified specialist should thoroughly explain to a woman the concept of cystic drift - what it is, what measures should be taken and what complications may be. He also observes the patient in dynamics and prescribes the necessary treatment.