Hydatidiform mole follow up and prevent

All patients with hydatidiform mole should follow up regularly, more importantly is regularly reviewed for two years, aimed at early detection of malignant transformation, but sometimes there may be remnants of the bubble-shaped moles. Patients should be advised at least two years to take effective contraceptive measures, the first six months should be reviewed once a month. In case of irregular vaginal bleeding, headaches or other Hemoptysis not feeling well, they should immediately go to the hospital to check.

Review period, when asked whether in addition to the normal outside the above-mentioned symptoms should also watch for. Check whether or not they should pay attention to the uterus flysch good, whether the vagina vulva violet blue nodules, chest film shows a shadow.

Pregnancy test in hydatidiform mole follow-up is very important to remove, about 60% of patients within 30 days of pregnancy test negative. Remains positive for more than 40 days should be highly suspected malignant or blisters are still remnants of fetal-like block.

In negative pregnancy test turn positive in the follow-up patients, such as non-pregnancy, malignant transformation should be highly suspected as the original urine positive dilution test has been negative, and referral in the dilution test was again positive in particular to increased dilution, and should be highly suspected malignant.

Postoperative hydatidiform mole, need to prevent Malignant transformation:
Hydatidiform mole is a disease caused due to pregnancy. Normal intrauterine pregnancy should the fetus and placenta, and uterus in patients with hydatidiform mole is not the fetus and placenta, but filled with numerous vesicles of various sizes like organization, blister tired because of these clusters, like grapes and is named after. The vast majority of the mole is benign, treatment is mainly through the curettage technique to remove intrauterine material. Some patients with hydatidiform mole after treatment by curettage and think that everything is over, can sit back and relax. If this kind of thinking is very dangerous because there are about 10% ~ 20% of patients with malignant transformation may occur.

Easy to transfer and malignant for hydatidiform mole:
The result of malignant transformation of hydatidiform mole, there are two: invasive mole (also known as malignant mole) and choriocarcinoma, both of the clinical manifestations and treatment of similar, but the degree of malignancy of choriocarcinoma higher and more prone to distant transfer, and the transfer of the occurrence of both early and extensive. Half of patients after curettage of hydatidiform mole, the number of vaginal bleeding can be stopped. Curettage after a few months if there is irregular vaginal bleeding, the number of indefinite quantity, or more than half a month after curettage vaginal bleeding is still continuing more than in the exclusion of residual mole should suspect the possibility of malignant transformation. Curettage after 1 ~ 2 months, gynecological examination revealed the uterus has not yet returned to normal size, or mass next to the uterus, and accompanied by abdominal pain, and should be timely for the blood of human chorionic gonadotropin (HCG) and B-checks to clear whether the occurrence of malignant transformation.

After malignant transformation of hydatidiform mole easy transfer, the most common organ for the transfer is the lung, vagina, brain metastasis. Lung metastases were the main symptoms of cough, blood sputum, such as hemoptysis and chest pain. Chest X-ray diagnosis is the most simple method, can be found on chest X-ray shadow of a small nodular; later, disease foci showed flocculence. Patient with transferred vagina, vaginal walls can be found in the nodules swell blue violet, metastatic nodules rupture can occur once the bleeding. More brain metastases secondary to lung metastasis, the main reason for the death. The early stage of tumor seized more than a sexual performance failure, blindness and other symptoms; period after entering the brain may be headache, vomiting, paralysis and coma and other symptoms, if the failure to control the patient's condition continued to increase in intracranial pressure can be deaths caused by brain herniation.

After Curettage should follow-up of hydatidiform mole for two years:
Follow-up reasons after Curettage of hydatidiform mole: First, due to the occurrence of hydatidiform mole after a greater chance of malignant transformation, and the other is the event of malignant transformation, the easy adoption of the blood circulation to distant metastasis, and often the symptoms of uterine disease has not yet appeared , but the transfer has been a distant organ. Therefore, regular follow-up after curettage of hydatidiform mole, malignant transformation of early detection and timely treatment, for a better therapeutic effect, with the utmost importance.

After curettage of hydatidiform mole should be a week for a quantitative measurement of HCG, until reduced to normal levels. The beginning of 3 months should be reviewed once a week, after three months, once every two weeks, once a month should be continued beyond six months, every two years instead of every half a year from a total of two years follow-up. Follow-up, in addition to monitoring the HCG, they also need to pay attention to any abnormal vaginal bleeding, cough, hemoptysis, and the transfer of the corresponding organ symptoms, gynecological examinations, pelvic B-and X-ray screening. In the two years follow-up should be to insist on condoms or vaginal contraceptive film financial, IUD can cause abnormal uterine bleeding, easy and after malignant transformation of the vaginal bleeding caused confusion; contraceptive containing estrogen can promote the growth of trophoblastic role in ancient capital can not be used.

Preventive chemotherapy in high-risk patients and reduce the malignant transformation:
Because hydatidiform mole is a disease caused due to pregnancy, so prevention for Hydatidiform mole is contraception measures to reduce the risk of pregnancy-free number will be hydatidiform mole, especially in women over the age of 40 are no longer as much as possible during pregnancy, because pregnancy is not only senior citizens mole the incidence of high and prone to malignant transformation.

After occur hydatidiform mole, need to guard against the occurrence of postoperative malignant transformation. Curettage of hydatidiform mole after close observation of changes in HCG is the most important guard against malignant measures. More than 12 weeks after curettage, HCG has been higher than the normal level, or reduced to normal levels once and then rapidly increased in hydatidiform mole and then rule out the possibility of residual post-pregnancy, suggesting that patients are at the early stages of malignant mole, should be given chemotherapy.

The prevention of hydatidiform mole postoperative malignant transformation, so far there is no ideal solution, but there is a tendency of high-risk patients with malignant transformation of preventive chemotherapy has the potential to reduce the incidence of malignant transformation. More than 40 years of age, than by the month of the uterus at or more than five on the size, HCG is greater than any unusual increase in the value of 105IU / L and their families in remote difficult to follow-up may take preventive chemotherapy. Curettage preventive chemotherapy should be 2 ~ 3 days before the start. Operation of curettage of hydatidiform mole was found mainly in small blisters, or pathological examination revealed a high degree of trophoblastic hyperplasia, atypical hyperplasia, or accompanied by, or curettage after HCG decreased to a certain high-value, no longer continue to decline, and may take selective chemotherapy, but also to reduce the role of malignant transformation.