Symptoms of cystic skidding after curettage

Hydatidiform mole is one of trophoblastic diseases. This pathology is considered to be quite rare, and is directly related to pregnancy. Molar pregnancy can be a complication of how her uterine and extra-uterine variety. Even after treatment, which is represented by curettage, often saved the signs and symptoms of the disease.

Hydatidiform mole is a pathological process ovum, particularly chorion from which the developing placenta. Hydatidiform mole accompanied by the transformation or chorionic villous shell in acinar formation called cysts. These formations are its size and shape resemble bunches of grapes.

bubbles filled a transparent liquid containing hCG, albumin, amino acids, globulins.

Molar pregnancy can develop during pregnancy, after its surgical termination, curettage, miscarriage, childbirth. In gynecological practice, also found cases of ectopic pregnancy, which is developing into one of the fallopian tubes.

species

Pathology may occur in several forms, which have different symptoms and signs.

In its histological structure of molar pregnancy is divided into the following forms:

• Easy;
• destruirujushchego, invasive;
• horionkartsinoma.

Hydatidiform mole differentiated according to the area of ​​lesion.

Complete molar pregnancy. This form develops within the first twelve weeks of pregnancy. Pathological degeneration process is characterized by the complete primary chorionic villi and hyperplasia diagnosed in two layers trophoblasts. In another way, this kind of may be called early molar pregnancy.

Among the manifestations of early full or hydatidiform mole can be identified:

1. pathological process, which is characterized by dispersal of the embryo;
2. absence of vessels in the villi;
3. degenerative changes in the epithelium of the chorionic villi, as well as its absence;
4. signs of swelling and an increase in chorionic villi;
5. trophoblast proliferation, which should cover the chorionic villi in their inner part.

Partial hydatidiform mole, or in another part. This disease occurs between the twelfth and thirty-fourth week of pregnancy. In this case, only the reborn of the chorionic villi. With this course of the disease there is a fruit that dies in the case of pathology and progression of destruction of one third of the placenta. If the pregnancy is multiple, the second placenta can be completely healthy.

According to the classification adopted in the world, with the malignant course of hydatidiform mole, to talk about its invasive form.

Hydatidiform mole, invasive has the following steps.

• Zero. Diseases marked low (0A) or high (0B) cancer risk.
• First. Malignant tumor does not extend beyond the uterus.
• Second. Determined by the individual metastases to neighboring organs located in the pelvis, vagina.
• Third. Signs of metastasis can be diagnosed in the lungs.
• Fourth. Observed metastases to distant organs such as the liver.

Hydatidiform mole invasive type more likely to develop due to the complete form. Invasive molar pregnancy is characterized by more severe course.

Among the signs of invasive hydatidiform mole can be noted:

• germination of bubbles in the myometrium;
• hyperplasia observed in the trophoblast, while preserving the structure of the villi;
• the spread of the villi of the muscular and serous layers of the uterus throughout the body, which is manifested organ damage.

Causes of

The disease occurs for several reasons, which lead to incorrect chromosomes in the embryo. In this case, the embryo has a double set of paternal chromosomes. This can occur when the loss or absence of the original maternal chromosomes in egg composition. A variant is also possible complete variety, in which simultaneously two fertilized ovum sperm. As a result, the embryo dies in the early stages, and chorionic villi continue their development. Incomplete embodiment hydatidiform mole chromosomes occurs mother delay. A so-called triplodiya, which leads to the death of the embryo in the first trimester of pregnancy due to various anomalies.

When triplodii in exceptional cases it is possible the development of the fetus, which is viable.

Molar pregnancy is a poorly understood disease. The exact causes of this phenomenon is not fully defined.

Scientists have developed several theories that can explain the emergence and development of hydatidiform mole.

• Viral effects. Under the influence of the activity of different viruses can occur pathological changes in a set of parental chromosomes.
• Inferiority egg. For some reason the egg defeat even in the ovary may occur, which leads to its misuse in the follicle maturation.
• Inflammation in decidua. Inflammatory processes, in particular, endometritis, cause changes in chorionic villi.
• Effect immunological factors. With the lack of the immune defective embryo is not rejected by the body in the form of abortion, which leads to the degeneration of the villi.
• Elevated levels of enzymes. This theory assumes an increase in the body such as an enzyme, hyaluronidase dissolving vessel wall.
• The lack of protein. The disadvantage of this component may cause a lack of a sufficient number of genes are present in the egg cell chromosomes after fertilization.

Highlighted certain factors that may provoke the emergence and development of hydatidiform mole.

• Age of mother. The risk group includes women under 18 and women who have stepped 40-year milestone.
• The number of births. In women with multiple births in the history of higher risk of hydatidiform mole.
• Amoproizvolnoe and surgical abortion. Repeating abortion, accompanied by curettage, abortions and cause the development of pathology.
• A weakened immune system. The decline of the body's defenses leads to the fact that the defective fertilized egg is not rejected by the body. As a result, there is a degeneration of the chorionic villi and the development of hydatidiform mole, which is treated with curettage.
• Deficiency of certain vitamins and trace elements. If a woman does not get along with food enough protein and vitamin A increases the risk of disease.
• Marriages among close relatives. Closely related communications are also one of the main factors for the disease.

By the appearance of hydatidiform mole can lead combination of adverse factors.

Symptoms and signs

Since the disease most often develops on the background of pregnancy, noticed the characteristic features is not always possible. Signs and symptoms of the pathology in these cases are accepted for the manifestation of a healthy pregnancy. Sometimes molar pregnancy is diagnosed during and after scraping.

symptoms may be missing up to two months.

Signs of hydatidiform mole.

• Early toxicosis. For typical heavy flow pathology toxicity, accompanied by vomiting, salivation, weakness, dehydration.
• Late toxicosis. In this case it appears with preeclampsia associated symptoms. A woman worries edema and hypertension. In the analysis of urine detected protein.
• Eclampsia. Symptoms of this condition can be detected after 12 weeks of pregnancy.
• Bleeding. Symptom common to all varieties of hydatidiform mole, including diagnosed after curettage.

Bleeding can be taken by women for miscarriage. Often the selection of bloody character coincide with the beginning of critical days. Prolonged and heavy bleeding are a threat to life and health of the woman.

• The large size of the uterus. In the case of the actual volume of uterine pathology longer due.
• Bubbles in spotting. This feature is typical for cystic skidding.
• Signs of "acute abdomen". The development of such symptoms suggests a possible hemorrhage in the peritoneum. Condition develops after germination chorionic villi in the muscular and serous membranes.
• Profuse bleeding. Most often, it occurs when an invasive species.
• Metastases. Such lesions are destruirujushchego mind and can be found in the vagina, lungs, brain.

Foci of metastasis after curettage may regress. However, in some cases, they can lead to a lethal outcome of the patient.

• Pain. A small percentage of women experience different intensity of pain in the lower abdomen and lower back. Often painful symptoms appear after bleeding. The emergence of aching pain is typical for germination to the serous membrane, while a sharp pain may indicate intra-abdominal bleeding.
• Thyrotoxicosis. Symptoms of this complication is accompanied by full form. As can distinguish symptoms such manifestations as tachycardia, tremor, increased thyroid.
• Embolism, respiratory failure. These signs indicate the full form and manifested by shortness of breath and cough.

Symptoms and signs of hydatidiform mole, in particular, after curettage, have individual character.

Methods of diagnosing and treating

Detection of the disease is difficult, as its symptoms are similar to polyhydramnios, fibroids, miscarriage, ectopic pregnancy.

Diagnosis is made by means of:

• history analysis;
• gynecological examination, during which determined the increased size of the uterus, its heterogeneity and components, as well as ovarian cysts, tumors in the vagina;
• Ultrasound reveals a fine fabric and the absence of an embryo or of his life;
• X-rays for the determination of metastasis;
• HSG to confirm the diagnosis and monitoring of treatment after curettage and chemotherapy;
• laparoscopy;
• hysteroscopy;
• assay for hCG;
• immunochemical and histological method;
• curettage.

Volume methods for diagnostic studies determined by the doctor based on the symptoms. Diagnosis is also made after scraping and chemotherapy in order to monitor the effectiveness of therapy conducted by.

Treatment of molar pregnancy involves:

• scraping;
• vacuum excochleation;
• the excitement of labor or cesarean little after 20 weeks of pregnancy;
• hysterectomy.

After conducted by scraping or delivery, the patient is on the account at the gynecologist. With further increase in hCG or detection of metastases symptoms woman receive chemotherapy some time after the curettage procedure.