Diagnosis of bubble drift does not represent difficulties. The diagnosis of a pregnant woman is made on the basis of an ultrasound study of the organs of a small pelvis and determining the level of chorionic gonadotropin.
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Bubble Diagnostics Methods
In connection with the development of ultrasound diagnostics, diagnosis «Bubble drift» It does not cause great difficulties, since the ultrasound painting is typical for this disease well known to those skilled in the art.
The laboratory diagnosis of this pathological state is based on the determination of a significant increase in the content of chorionic gonadotropin in serum (up to 500 me / ml) or its daily excretion (the amount of selection per day in blood).
A high-quality pregnancy test with urine can also be used to diagnose bubble drift, but urine must be diluted at 20-50 times. Positive result in this case confirms the diagnosis of bubble. The diagnostic accuracy of the method is 70-80%, since the disease may be accompanied by a normal or even reduced secretion of chorionic gonadotropin. In these cases, the determination of the quantitative level of the chorionic gonadotropin in the blood is pregnant - the lack of physiological reduction in the secretion of chorionic gonadotropin after 13-14 weeks of pregnancy, and even more so the growth of the hormone in the blood of the mother after this period with high reliability confirms the diagnosis of bubble drift.
Treatment of bubble drift
Treatment of a benign shape of the trophoblastic disease of the bubble drift is mainly reduced to its removal by vacuum-aspiration - suction of the contents of the uterus using metal cylindrical tips and an electrovacuum pump.
After histological confirmation of the diagnosis (research under the microscope of the material obtained from the uterus), the patient should be sent to a specialized institution of an oncological profile.
Observation for 8 weeks after surgery includes the study of chorionic gonadotropin in serum once a week and ultrasound of a small pelvis (ultrasound) once every two weeks.
In the absence of signs of the disease (normal indicator of chorionic gonadotropin up to 15 MME / ml, the absence of tumor formations according to the ultrasound of a small pelvis and X-ray study of the lungs, as well as the restoration of a normal menstrual cycle) Chemotherapy do not conduct.
Further study of chorionic gonadotropin in serum is carried out 1 time in two weeks for 3 months, and then - 1 time per month for six months. The optimal term for the occurrence of desired pregnancy - a year after the evacuation of the bubble drift.
In case, after 8 weeks after the evacuation of the bubble drift, it is not observed normalizing indicators of chorionic gonadotropin or a tendency to increase the chorionic gonadotropin, the patient is prescribed an in-depth examination, since these results of analyzes suggest that bubble cells are preserved in the uterus or other bodies and produce xg.
According to the ultrasound of a small pelvis, the foci of bubble drift in the uterus can be revealed, and with a radiological study of the lungs - metastatic defeat. Such patients are prescribed chemotherapy. Most often to treat this disease, methotrexate and dactinicine chemotherapy products are used or a combination of them in combination with leacover. The treatment is carried out until the normalization of indicators of chorionic gonadotropin, the restoration of the menstrual cycle, the disappearance of pathological foci in the uterus and lungs. However, it must be remembered that fibrous changes - the foci of the connective tissue on the site of pathological foci in the uterus and the lungs - can be maintained quite a long time, despite full recovery.
After reaching clinical and laboratory remission (period, when there are no symptoms of the disease and all analyzes in normal), 2-3 preventive chemotherapy courses are carried out by the same drugs.
After treatment, the patient remains under the supervision of an oncologist's doctor for 1-1.5 years (during this time each month the determination of chorionic gonadotropin in blood serum is determined). At this time, it is recommended to refrain from the occurrence of pregnancy, while the optimal prevention option from unwanted pregnancy is hormonal contraception, which simultaneously with the contraceptive effect regulates the function of the ovaries, impaired due to the suffering disease and chemotherapy conducted.
Timely diagnosis and proper medical tactics allow you to preserve the reproductive function of a woman and guarantee the onset of normal pregnancy and subsequent birth. 90% of patients who received chemotherapy, menstrual function fully recovered, and in 70% there was a pregnancy, which ended with normal childbirth.
It should be noted that pathological changes in children born by women after transferred bubble drift are somewhat more common than in children of healthy women. At the same time and pathology in childbirth (bleeding, weakness of labor duration and t.D.) Patients who suffered a trophoblastic disease was slightly higher compared to healthy women. This fact suggests that after this disease, a woman needs a particularly careful control from doctors.
