In order to ensure the normal nutrition and development of the unborn child, its outer shell (chorion) forms in its branched part villi, similar to the roots of the tree, which grow into the mucous membrane of the uterus. Chorion is formed from the outer shell of the embryo (trophoblast). First, there are primary villi - the processes, then the connective tissue grows in them (secondary villi), and the last ones - the blood vessels that supply the embryo (tertiary villi).
Bubble skidding - causes and development of the disease
A rare but very serious disease that is directly related to pregnancy is a bladder drift. Its exact cause is unknown. During the disease, there is an increase in the size of the villus of the chorion, the appearance in it of cystic enlargements with liquid resembling grape clusters.
The nails grow very fast, they have few blood vessels that are needed for the fetus, but many swelling, rapidly growing villi with fluid vesicles. There are three types of drift:
- Incomplete (partial) bladder skidding - the disease only captures part of the placenta, develops after 3 months of pregnancy. The fetus dies only when more than a third of the placenta is involved.
- Full bladder drift - the entire placenta is damaged, in the chorion there are no blood vessels, only edematous connective tissue, and in the uterus there is no embryo.
- Destructive bladder drift - the disease behaves like a tumor. Vorsinki germinate not only the mucous membrane, but all layers of the uterus, spread along the blood and lymph vessels to other organs of the abdominal cavity.
Bumpy skid - symptoms and diagnosis
Pregnancy in the initial stages of a bubble drift is as usual - there are no monthly, the uterus increases in size, a strong toxicosis develops, an increase in blood pressure. But sometimes after 8 weeks the uterus starts to grow too quickly, and in the period from 8 to 18 weeks there are bloody discharge of different intensity and duration. They do not cease with destroiruyuschey skidding even after its removal, the heartbeat of the fetus is not listened.
For diagnosis use is made of the level of human beta-chorionic gonadotropin (hCG), normally its amount in the blood does not exceed 100,000 mIU / ml at 10 weeks of gestation. The level of hCG with a bubble drift grows 2-3 times.
In ultrasound, the disease is most accurately determined: the uterus is partially or completely filled with small vesicles with fluid. Partial bladder drift may retain parts of the fetus, but palpitations and movements are often no longer present, and bilateral luteal cysts are found on both ovaries. If there is spotting, then when they are microscopically examined, the altered villi of the chorion is sometimes found.
Treatment of bladder skidding
The main method of treating cramps after his diagnosis remains its immediate removal. With uterine sizes up to 12 weeks, surgical intervention is often avoided, and the bladder skeleton is removed by medication: prescribing drugs that shorten the uterus and remove its contents.
If the effect is not enough - removed by scraping the uterus with a blunt curette or vacuum removal (in pregnancy up to 5 weeks) with the subsequent appointment of contraction and styptic drugs.
If after 2 weeks the spotting returns, then the scraping is repeated, the contents of the uterus are sent for histological examination. If bleeding can not be stopped, the uterus exceeds 20 weeks in size, then the bladder skeleton is removed by caesarean section.
When destructive bladder drift, which is accompanied by severe bleeding, remove the entire uterus, leaving the appendages. After removing the skid for 2 months, control the level of hCG, which should return to normal. If this does not happen, the patient is prescribed a course of chemotherapy.
Even if the treatment is successful, the woman should be under the supervision of a gynecologist for another 2 years, consult an oncologist. Follow-up pregnancy after bladder skidding is recommended not earlier than after 1 year.