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Bubble skid - what is it?

Pregnancy is a sacrament from the first to the last day of it, it is a state of expectation, an increasing sense of responsibility. With all the wonders of modern diagnostics, able to predict the multiplicity, find out the sex of the child, tell about his health - the upcoming meeting with the baby cares and pleases.

And suddenly at this time of hope, like a bolt from the blue, a diagnosis sounds - a bubble skid.

Content

Bubble skid - what is it during pregnancy?

Bubble skid

Bubble skid is one of the worst complications of pregnancy, with serious consequences and requiring emergency treatment. In the uterus, the development of the outer shell of the fetus with the development of multiple hollow elements filled with protein secretion is disturbed. They are connected to each other by connective tissue trunks, creating a picture of a bunch of grapes.

The fetus, with the exception of the rarest cases, dies, and its outer shell (chorion) grows into an independent tumor.

Some information about the processes occurring in the uterus

The newborn girl has about 400 thousand of already formed eggs, some of which, when they reach puberty, in turn leave the ovary, creating the prerequisites for pregnancy. If it has not come, then the inner lining of the uterus is rejected with menstrual blood so that in a month the new mucous membrane is ready for pregnancy.

Already on the 5-6 day of pregnancy, 25-150 mU / ml of the specific hormone HCG (human chorionic gonadotropin) is determined in a woman’s blood, the purpose of which is to inform the woman about the onset of a new condition that requires a change in hormonal levels. This hormone is produced by the chorion.

It is on the detection of hCG and based tests for the determination of pregnancy with the establishment of the exact date of its occurrence.

The maximum concentration of hCG reaches three months of pregnancy, then its level decreases. A decrease or increase in hCG levels compared with the norm allows doctors to diagnose many problems during pregnancy. When blistering the level of hCG increases.

Causes of blistering

Several theories explain the occurrence of this pathology, and each of the assumptions is confirmed in medical practice.

Часть исследователей видит причину в периоде эмбрионального развития женщины, у которой наблюдается пузырный занос. 1. Some researchers see the cause in the period of woman's embryonic development, in which there is a bubble skid.
According to them, due to improper splitting of the cell nucleus, the ovaries of the female embryo do not receive a chromosome set (half of the germ cells - 23 out of 46 - have a set of chromosomes, so that when the two cells merge, a full set of the body develops).

If an egg cell that does not contain chromosomes has fertilized, then only with paternal chromosomes the new organism will not develop. Unclaimed chorion begins independent development inside the uterus.

Есть мнение, что пузырный занос может развиться и в случае, когда в нормальную яйцеклетку проникают или один сперматозоид с двойным набором хромосом или два сперматозоида, и тогда дополнительные 23 хромосомы оказываются лишними, вызывая гибель плода на более поздних сроках. 2. There is an opinion that the bubble skid can also develop in the case when one sperm cell with a double set of chromosomes or two sperm cells penetrates into a normal egg, and then an additional 23 chromosomes appear to be superfluous, causing death of the fetus in later terms.

Ещё одна группа учёных отстаивает версию, что виной всему является дефект внутренней оболочки матки (эндометрия), возникший вследствие частых абортов, диагностических процедур, инфекций мочеполовой сферы. 3. Another group of scientists defends the version that the fault is the defect of the inner lining of the uterus (endometrium), resulting from frequent abortions, diagnostic procedures, infections of the genitourinary sphere. When attaching to the unhealthy part of the uterus, the chorion begins to develop in the form of a blistering skid.

Часть клиницистов во время обследования пациенток с такой патологией выявляют изменённую ткань яичников, что даёт им право предположить, что развитие яйцеклетки нарушается именно там, и пузырный занос — следствие изменений, прежде всего, в яичнике. 4. A part of clinicians during the examination of patients with this pathology reveal altered ovarian tissue, which gives them the right to assume that the development of the egg is disturbed there, and the gallbladder is a consequence of the changes, primarily in the ovary.

Некоторые усматривают вирусную природу развития заболевания. 5. Some see the viral nature of the development of the disease.

Есть ферментативная и иммунологическая теории, объясняющие неправильное развитие хориона биохимическими процессами. 6. There are enzymatic and immunological theories explaining the abnormal development of the chorion by biochemical processes.

Classification

  • Distinguish between simple and invasive (destructive) blistering skid.
  • A simple form is divided into full and partial.

When the vesicle is completely full, the entire chorion is involved in the process, the embryo quickly decides, and the pathology is detected in the early stages.

Partial vesical drift - detected at 9-34 weeks, it is characterized by a local degeneration of the outer shell of the fetus.

The most severe form is destructive. When it is, the chorionic villi, which normally contain blood vessels for feeding the embryo, grow into the uterine wall, causing its thinning, internal bleeding and contamination with the pathological cells of other organs.

Bubble drift: symptoms and signs

Bubble drift: symptoms and signs

Signs of a skidding are quite characteristic and allow not to be mistaken in the diagnosis.

A woman at the reception complains of the appearance of bloody brownish discharge , pain in the abdomen, vomiting, increased salivation, palpitations, fever and deterioration of the general condition.

When taking measurements, the doctor notes that the volume of the abdomen and the size of the uterus correspond to a longer gestation period, and the fetal head, heartbeat and movement are not determined, weight loss and an increase in the level of protein in the urine are noted.

Sometimes develop eclampsia with a sharp increase in blood pressure.

Additional diagnostics

To determine the form of the disease studies are conducted:

  • The first ultrasound of the uterus and appendages;
  • Laparoscopic echography - an ultrasound probe is inserted into the abdominal cavity through a small incision;
  • Diagnostic laparoscopy - examination of the external wall of the uterus with the help of optics;
  • Hysteroscopy - the study of the inner wall of the uterus with the help of optics;
  • Phonocardiography - an attempt to detect the heartbeat of the fetus;
  • Radiography of the abdominal cavity and chest and hysterosalpingography -
    R-images of the uterus and appendages;
  • Consultation oncologist, endocrinologist, nephrologist and surgeon.

Consequences and complications

Cystic drift causes negative consequences in the form of infertility, which occurs in 30% of women who have suffered it, as well as the absence of menstruation ( amenorrhea ) in 12%.

Septic complications and thrombosis may develop. The most serious complication is the development of malignant chorionic carcinoma, in which, in addition to the uterus, the tumor affects the liver, the vagina, lungs and the brain with a fatal outcome.

In addition, malignant tumors may develop that do not extend beyond the uterus.

Treatment of blistering

Treatment of blistering

If a bubble skid is set, the woman enters the hospital. First of all, life-threatening complications are treated: eclampsia, anemia, thyrotoxicosis.

Then remove the bubble skid - with a small period of pregnancy for this purpose, carry out the scraping of the bubble skid or vacuum aspiration.

In the second half of pregnancy (more than 20 weeks), an attempt is made to reject a tumor with the help of drugs that stimulate labor. If unsuccessful, a cesarean section is performed with curettage of the uterus or the complete removal of the uterus, leaving the ovaries.

After discharge from the hospital, a woman is placed on dispensary registration.

If the regular menstrual cycle has not recovered and there is bloody discharge:

  • they do a pelvic ultrasound every two weeks, and after restoring the cycle - once every three months for a year;
  • once a week, control of hCG is carried out until its normal level is restored;
  • during two years they make an analysis for hCG once a month;
  • radiography of the lungs is periodically repeated in order to detect metastases;
  • hormonal contraception for two years to restore ovarian function.

If an elevated level of chronic hepatitis remains, or a further increase is noted, if an invasive form of anxiety or its metastasis is detected after the operation, if a histological examination of anxiety has shown a malignant transformation, then a second stage of treatment is performed - chemotherapy using Dactinomycin, Methotrexate or Leucovorin ", combining both of these funds.

With a favorable outcome of the treatment of blistering 70% of women can count on the possibility of a new pregnancy two years after a course of chemotherapy. Naturally, it will take place under the special supervision of a physician.

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