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Gestational Trophoblastic Disease: Symptoms, Diagnosis and Prevention

Gestational Trophoblastic Disease: Symptoms, Diagnosis and Prevention

Gestational Trophoblastic Disease: Symptoms, Diagnosis and Prevention

Gestational Trophoblastic Disease: Symptoms, Diagnosis and Prevention
- Trofoblas gestational disease is a disorder in the form of the proliferation of abnormal cells trophoblast during pregnancy that includes complete or partial hydatid molas, mola invasive, choriocarcinoma and placental site trophoblastic tumor. About 10% of cases of gestational trophoblast disease developed into the process of malignancy that requires further action. Trofoblas gestational disease includes mola invasive, placental site trophoblastic and choriocarcinoma tumors. Trofoblas gestational disease is a malignant tumor that originates from the sinsiotrofobals and sito invades myometrium, damaging the surrounding tissues and blood vessels causing internal bleeding.
    Main topic : 
  1. Causes of gestational trophoblastic disease
  2. Symptoms gestational trophoblastic disease
  3. Diagnosis of gestational trophoblast disease
  4. Prevention of gestational trophoblast disease

Gestational trophoblastic disease can be preceded by process of fertilization (hydatidiform mole, healthy pregnancy, ectopic pregnancy, and abort) can even be a product directly from the results of conception or that is not preceded by a pregnancy. Trofoblas gestational disease which preceded the process of fertilization of the ovum is classed as "choriocarcinoma with pregnancy" (gestational choriocarcinoma) while not preceded the propagation of the egg is known as choriocarcinoma without pregnancy (gestational choriocarcinoma non), i.e. originating from tumor cells germinal in the ovaries.

Causes of gestational trophoblastic disease

The purpose of the occurrence of the illness trophoblast gestational yet precisely known, but it is a form of tumor malignancy carcinoma epithelial korion despite growth and metastasis resembles a sarcoma. Also, in General, the disease is caused by the presence of pregnancy wine or hydatidiform mole. However, two theories are stating the cause of the occurrence of the disease trophoblast gestational, namely :

1. The theory of missed abortion

The embryos die at 3-5 weeks of pregnancy (missed abortion). Because it happens, so that blood circulation disturbances occur in the tissue fluid mesenchyme of hoarding and villus and ultimately resulting in bubbles. According to Reynolds, death due to malnutrition in the form of folic acid in pregnancy histidine and the 13th and 21st, causing impaired angiogenesis.

2. Theory of Neoplasm

Trophoblast cells are abnormal to have abnormal function anyway, where excessive liquid resorption into the villus so arising bubble, causing the circulatory disorder and the death of the embryo.

Symptoms gestational trophoblastic disease

Irregular bleeding after the end of a pregnancy and where there are subinvolution uteri also bleeding can be continuous or intermittent with sudden and sometimes massive hemorrhage. On gynecology, the examination found the uterus is enlarged and tender. Tekalutein bilateral cysts. Metastatic lesions in the vagina and other organs. Bleeding due to uterine perforation or metastatic lesions :
  • characterized by abdominal pain
  • coughing blood
  • Melena
  • increased intracranial pressure in the form of a headache
  • hemiplegia and spasm.
Levels of hCG β post mola after declining, not decreased even could rise again, or the hCG β titer rises after termination of pregnancy, mola or abort. Examination photo thorax can be found the presence of metastatic lesions. Histopathology can be observed in the material of villus however by not showing the picture of pathology cannot exclude malignancy.

Diagnosis of gestational trophoblast disease

Diagnosis of malignant trophoblast disease clinically enforced based on:

Anamnesis.

  • The bleeding continued after the evacuation of mola or previous pregnancy
  • In the case of uterine perforation, discovered the existence of complaints of abdominal pain
  • When there is a metastatic lesion, then can be found hemp to symptoms, headaches, seizures, and hemiplegia.

Physical examination

  • Large uterus and irregular
  • Can be seen in the presence of metastatic lesions in the vagina or other organs
  • Lutein cyst found persistent bilateral

Complementary examinations

  • Found the levels of hCG β settled or rising
  • On the photo, the thorax can be seen the presence of metastatic lesions
  • Pelvic ULTRASOUND, liver, and kidneys to see any metastasis
  • If there are metastases in the liver so it can be found as liver function disorder
  • A CT scan of the head when there are indications of nerve disorders

Prevention of gestational trophoblast disease

In the case of high risk when the desired number of children are already sufficient, so that performed a hysterectomy. Giving chemotherapy against cases of ectopic pregnancy to prevent the disease troubles.
When the titer post hCG β mola not down-down for three weeks consecutive ordered or even more and ride may be given chemotherapy, unless the child had enough can be done a hysterectomy.

Tag :
Gestational Trophoblastic Disease: Symptoms, Diagnosis and Prevention
Symptoms and diagnosis gestational trophoblastic disease
Symptoms and prevention gestational trophoblastic disease
Diagnosis and prevention gestational trophoblastic disease
Symptoms gestational trophoblastic disease
Diagnosis gestational trophoblastic disease
Prevention gestational trophoblastic disease
Gestational trophoblastic disease
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