Hydatidiform mole Treatment

1. Complete curettage of uterine cavity. Hemorrhage due to hydatidiform mole may at any time, so the diagnosis is confirmed, should be content to clear the uterus, general surgery using suction Palace. Smoking in the contents of the process, gradually narrowing the uterine body, hardened. Although aspiration of material with more volume, but most of the original plot for the uterine blood, the patients pulse, blood pressure showed little change in general. Many people claim more than the uterus such as the navel, should be adopted by the abdominal caesarean mole check that this would completely wipe out under direct vision and better hemostasis. However, in practice, even if the uterus to swell big seven or eight months pregnant, and the application of suction operation can successfully clear the palace. Such as the need for hysterectomy in the palace immediately after smoking. Caesarean renvoi Hu check to make mole mole cultivation, the transfer may be. No smoke Gong equipment may be in the expansion of the cervix, the clamp mole.

Complete curettage of uterine cavity do not have too perfect at first time, resulting in injury of the soft-walled palace. Can be about one week, then the second curettage surgery.

Often the treatment of patients after curettage, there are still bleeding, will treatment with in accordance with the situation at the time. Mole suspected incomplete abortion (suction curettage incomplete or have a new blister), curettage may be prudent to conduct a comprehensive, if still bleeding, and should be considered invasive lesions palace wall, details of which are malignant mole and choriocarcinoma.

Hydatidiform mole spontaneous abortion are also curettage of uterine cavity. In surgical procedures, if good uterine contraction that do not use contraction agents, only when the bleeding and the bad uterus contraction, intravenous uterine contraction agents.

2. Hysterectomy. Over 40 years of age, or more speed up the maternal uterus, the hysterectomy should advise the young to consider retaining the ovaries. Uterus is greater than 5 months of pregnancy in the first resection, should be clear vaginal blisters like the majority of intrauterine fetal blocks, so as to facilitate processing operations.

3. Blood transfusion. Severe anemia should be given a small amount of blood transfusion several times slowly, and closely observe the patient whether or not the activities of bleeding, when the situation improved to some extent after the implementation of curettage surgery. Activities in the event of bleeding should be in the Palace at the same time, be a blood transfusion.

4. Correct electrolyte imbalance. Long-term bleeding, loss of appetite often have dehydration, electrolyte imbalance should be corrected check.

5. Control infection. Long-term uterine bleeding, or the operator repeatedly dirty easily lead to infection, manifested as local (uterine or annex) infection or sepsis. Anti-inflammatory drugs should be adequate; and actively correct the anemia and electrolyte imbalance.

6. Chemotherapy. Invasive hydatidiform mole is main chemotherapy treatment, supplemented by surgery, but surgery still have an important role in the control of bleeding, infection and complications such as removal of residual or resistant disease.

Use medication, including fluorouracil, actinomycin D, methotrexate and calcium folinate rescue drug, cyclophosphamide, vincristine, etoposide, cisplatin and so on. Use the principle: I usually use single-drug treatment; Ⅱ - Ⅲ period to use the combination chemotherapy; Ⅳ or drug-resistant cases were EMA-CO with the program, the high rate of complete remission, side effects small. Table 36-4 lists several chemotherapy. Side effects: mainly in hematopoietic dysfunction, followed by gastrointestinal tract reactions, liver dysfunction is also common, severe cases can be fatal, treatment should pay attention to prevention and treatment process. Common hair loss, can be recovered after drug withdrawal. Drug indications: chemotherapy to be continued until symptoms and signs disappeared, HCG determination once a week, for 3 times the normal range, and then 2-3 months to consolidate treatment, follow-up 5-year relapse-free for the cure.