Xu Fang after malignant mole

Hydatidiform mole is a disease caused by pregnancy. Uterine cavity normal pregnancy is fetal and placental, and hydatidiform mole in the womb have not fetus and placenta, but with numerous-size blisters, tired, manifested by these blisters, like grape named. The majority of the mole is benign, mainly through the treatment of curettage, removal of the uterine cavity. Some patients with hydatidiform mole curettage after treatment, it has been thought that all the past, can sit back and relax. If this kind of thinking is very dangerous, because about 10% to 20% of the patients to the possibility of a malignant transformation.   YI YI malignant mole transfer  Hydatidiform mole malignant transformation is the result of two kinds: invasive hydatidiform mole (also known as malignant mole) and choriocarcinoma, the two similar clinical manifestations and treatment, but the degree of malignancy choriocarcinoma higher and more prone to distant transfer, and a transfer of both early and extensive. Half of patients with hydatidiform mole after curettage, vaginal bleeding can be stopped. If few months after curettage appeared irregular vaginal bleeding, the number of volatile, or more than half a month after curettage still vaginal bleeding, sustained more than in the residual exclude hydatidiform mole, should doubt the possibility of malignant transformation. Curettage after 1 to 2 months, gynaecological examinations found uterus has not been restored to normal size, or uterine next to a mass, and accompanied by abdominal pain, blood should be timely for human chorionic gonadotropin (HCG) and B-checks to clear whether in malignant transformation.  After malignant mole easy transfer, the most common transfer of organs for lung, followed by the vagina, and brain metastasis followed. Pulmonary metastasis main symptoms are cough, Xuetan, such as chest pain, and hemoptysis. Chest X-ray is the most simple diagnostic methods, in the chest film can be found on small nodular shadows; later, the disease was Mianchuzhuang vaginal lesions can be transferred, can be found in vaginal wall violet blue uplift nodules, Rupture of metastatic nodules may occur once the bleeding. Many secondary brain metastases in lung metastasis after death is the main reason. Early stages of the seizure of more than one-off performance of mistakes, blindness symptoms after entering brain period, there may be headache, vomiting, and other symptoms of hemiplegia and unconscious, if not timely controlled conditions, increased intracranial pressure continued, died from cerebral hernia.   Curettage after the 2-year follow-up must uphold  Hydatidiform mole curettage follow-up after treatment to the reasons: First, because of a hydatidiform mole after a greater chance of malignant transformation, and the second is the event of malignant transformation, easily through blood circulation to distant metastasis, uterine disease symptoms are often not yet in , but the transfer has been a distant organ. Therefore, regular follow-up after curettage hydatidiform mole, the early detection of malignant and timely treatment for better treatment results, has a very important significance.  Hydatidiform mole after curettage, a weekly for quantitative measurement of HCG, until reduced to normal levels. Started three months should be reviewed once a week, after three months, once every two weeks, once a month should continue after six months, every two years instead of every six months from the time of follow-up of 2002. Follow-up, in addition to monitoring HCG, they also need to pay attention to whether abnormal vaginal bleeding, cough, hemoptysis, and the corresponding transfer of organs symptoms of gynaecological examinations, as well as B-pelvic X-ray inspection. In the 2002 follow-up, we should insist on condoms or vaginal contraceptive film Rong, the intrauterine device will cause abnormal uterine bleeding, easy and postoperative malignant transformation vaginal bleeding caused by confusion; contraceptive containing estrogen can promote the growth of trophoblast cells , Gudu not be used.   Preventive chemotherapy in patients with high-risk or reduce the occurrence of malignant transformation  The mole is a disease caused by pregnancy, as long as doing a good job of family planning, contraception implement measures to reduce the number of pregnancy can be free from hydatidiform mole, especially women over 40 years of age as far as possible, not pregnancy, because pregnancy is not only senior citizens in the hydatidiform mole rate high, and prone to malignant transformation.  To beware after a hydatidiform mole after malignant transformation. Hydatidiform mole after curettage watched HCG beware of malignant change is the most important measure. Curettage after more than 12 weeks, HCG consistently been higher than the normal level, or had once dropped to a normal level after the rapid increase in the residual hydatidiform mole and again ruled out pregnancy, has been suggested that patients with malignant mole in the early stages, should be timely given chemotherapy.  Prevention hydatidiform mole after malignant transformation, so far there is no ideal solution, but tend to have a high-risk patients with malignant preventive chemotherapy has the potential to reduce the incidence of malignant transformation. Age greater than 40 years old, significantly higher than the uterus or more in five months size, HCG unusual increase in value greater than 105 IU / L and family follow-up to the remote, can take preventive chemotherapy. Curettage preventive chemotherapy should be 2 to 3 days before the start. Curettage of the hydatidiform mole found mainly in small blisters or pathological examination revealed a high degree of trophoblastic hyperplasia, or with atypical hyperplasia, or HCG after curettage dropped to a certain high-value, will not continue to decrease, can be taken selective chemotherapy, but also reduce the role of malignant transformation.