What is Molar Pregnancy?
Molar pregnancy is an abnormality seen in the baby's partner, which we call the placenta, adhering to the mother's womb. In this disease, swelling, edema and water collection occur in the baby's finger-like protrusions called villi, which stick to the mother. Water vesicles form in the finger-like protrusions. and their appearance resembles a bunch of grapes.
What is its frequency?
Although the incidence of molar pregnancy is 1 in 1000, the risk of occurrence increases 10 times in pregnant women who have had a molar pregnancy before.
How many types are there?
There are two types of molar pregnancy.
1) Complete or Classic mole: In this case, the pregnancy consists of abnormal tissues found only in the baby's partner (placenta). There is no tissue belonging to the baby in the uterus. It is the most common type of molar pregnancy. In a complete mole, 46XX, that is, a girl chromosome, is seen, but these two sex-determining chromosomes are abnormally inherited from the father.
2)Partial mole: It is found in the tissues of the baby along with abnormal placental development in the pregnant woman. In partial mole, polypoid chromosomal abnormalities are usually dominant and Triploidy is often observed. In other words, a normal egg cell is fertilized by two sperm. Even if the baby is developed in the pregnant woman, there is no chance of survival due to the genetic defect in the baby.
In whom is it most common?
1)In older expectant mothers, especially over the age of 40
2)In young expectant mothers, especially under the age of 20
3) In pregnant women with low socioeconomic status
4)In malnourished women
5)In Far Eastern and Mexican women
What are the symptoms?
1) Vaginal Bleeding
2) What we call Hyperemesis Gravidarum is excessive nausea and vomiting seen during pregnancy. It usually has a course that is resistant to treatment.
3) Gestational Hypertension is seen especially in the first months of pregnancy. It is generally seen after the twentieth week of pregnancy.
3) Symptoms of hyperthyroidism are observed. These can be listed as hot skin, tachycardia, that is, palpitations, and enlargement of the thyroid gland.
4) Trophoblastic embolization, that is, these abnormal tissues enter the mother's blood and affect the respiratory system. Symptoms such as cough, shortness of breath, pale skin and bruising caused by This What are the conditions?
1) In more than half of the pregnant women, the uterus is larger than the expected gestational age. The reason for this is the faster proliferation of abnormal tissue and bleeding inside the uterus.
2) In the vaginal pregnancy examination, the uterus is also very soft.
3) The appearance of bilateral Theca Lutein cysts of 8cm and larger in the ovaries. .
How is the diagnosis made?
The data are evaluated after listening to the patient's complaints and examination. The patient is subjected to ultrasonographic examination. On ultrasound, a typical snowstorm appearance created by multiple echoes within the uterus is observed. In addition, an excessively increased Beta HCG in the blood compared to the week of pregnancy supports the diagnosis.
How is the treatment performed?
After the diagnosis is confirmed. The diseased material in the uterus should be evacuated before complications related to the disease develop. Before the material in the uterus is evacuated, the patient is subjected to blood count and biochemical tests. Since the uterus is very soft, the tone of the uterus is increased by giving 10-20 units of oxytocin in 1000ml of liquid before evacuation. The patient is prepared for curettage under general anesthesia. First, Suction (vacuum) Curettage is performed and the material in the uterus is almost completely emptied and placed in a separate container for pathological analysis. Then, carefully curettage is performed with a Sharp curette to collect the remaining material and completely empty the uterus, and this material is placed in a separate container for pathological analysis. After bleeding control, curettage is performed. is terminated.
How is follow-up done after treatment?
1) Chest X-ray is taken before curettage. In follow-up, it is repeated in the 4th and 8th weeks after curettage.
2) Beta-HCG is continued for three consecutive weeks until a negative value is obtained. Then, the analysis is repeated every month for six months and every two months for the remaining six months for a total of one year. Generally, the values decrease to normal values fourteen weeks after curettage. During this period, Pregnancy is prevented with birth control pills. If the follow-up course of the disease does not continue like this, if there is resistance to treatment or an increase in beta-hCG, it should be evaluated whether the cancer form of the disease has developed. Cancer develops in 20% of patients who develop a complete mole.
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