During the early pregnancy phase, the normal development process does not occur for reasons we do not yet know exactly, and molar pregnancy (gestational trophoblastic disease [GTH]), a condition in which the baby does not develop or develops abnormally and the cells that will form the baby's partner proliferate and grow out of control, develops. In short, GTD is a cancer-like or cancer-like process that develops after the fertilized egg implants into the uterus.
Environmental factors; Low socioeconomic level, diet (the risk is higher in those with a low-carotene diet) and maternal age under 17 and over 30 are thought to be important in the development of this disease. GTD is most common in Asia.
It responds very well to treatment. It is collected under two main headings; mole pregnancy (hydatidiform mole) and mole cancer (choriocarcinoma).
A- Mole pregnancy (Hydatidiform mole): This form, also called mole pregnancy, is the non-cancerous form of GTH. Abnormal growth and proliferation of cells causes the development of a cystic structure resembling a "cluster of grapes", which is the characteristic appearance of the disease. Because of this appearance, GTH is also known as grape pregnancy among the public.
B- Mole cancer (Chriocarcinoma): It is the cancer form of GTH. Here the disease can spread to the whole body. Complaints may initially include severe nausea and vomiting. The blood level of ß-HCG, known as a blood pregnancy test, is often higher than expected. This is the main reason why pregnancy complaints are more pronounced. Accordingly, in patients with GTD, the thyroid gland functions more frequently than normal, and this may require treatment. In addition, pregnancy-induced high blood pressure and pregnancy poisoning may develop in patients earlier than expected (before the 20th week of pregnancy). Additionally, if the disease has spread throughout the body, complaints about the places where it has spread may also be seen. Miscarriage is not a real miscarriage, but rather the shedding of cells that have grown and expanded and turned into a bunch of grapes. It is mostly defined by patients. The disease can be easily identified by ultrasonography (USG).
The treatment of hydatidiform mole is evacuation of the uterus. This procedure is mostly performed by the method we call dilation & curettage (D&C) and popularly known as curettage. �r. Curettage material should definitely be examined in pathology. Following the evacuation process, our non-cancer patients are called for regular follow-ups. During these follow-ups, the decrease in blood ß-HCG level is observed. ß-HCG level decreases to normal at a certain rate and usually within 8 weeks. It is important that the patient under follow-up does not become pregnant in the first 6 months. The reason for this is that ß-HCG increases with pregnancy, and an increase in ß-HCG in the follow-up patient can be considered as a recurrence of the disease. This may lead to unnecessary interventions and treatments. In the first 6 months, the person usually uses birth control pills to prevent pregnancy.
If the ß-HCG level does not decrease or increases during follow-up, if the result of the part taken by D&C is mole cancer (choriocarcinoma), if there is a finding regarding the spread of the disease, this is The condition is called gestational trophoblastic tumor (GTT). The treatment of GTT is chemotherapy and its follow-up is different.
Following chemotherapy, patients are monitored for the course of the disease with blood ß-HCG levels. A complete response is considered to be a serum ß-HCG level below 10mIU/ml for three consecutive weeks.
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