妇产科学课件：妊娠滋养细胞疾病(英文版).pptx

Gestational Trophoblastic Diseases (GTDs);2;2021/5/11;4;Introduction ;Classification;7;Hydatidiform mole;Incidence and epidemiology;High risk factors women 20 and 35-40 years Low economic status Nutrition: diets deficient in protein, folic acid, and carotene;;Etiology; 细胞遗传学研究表明: 因染色体变异、卵子不正常，致受 精缺陷， 空卵受精，双精子受精 ;2021/5/11;2021/5/11;2021/5/11;Pathology ;2021/5/11;2021/5/11;2021/5/11;2021/5/11;2021/5/11;2021/5/11;Pathology ;2021/5/11;2021/5/11;Comparison of complete and partial HM;β-hCG;2021/5/11;Theca-lutein cysts a type of bilateral functional ovarian cyst filled with clear, straw-colored fluid. To be classified a functional cyst, the mass must reach a diameter of at least three centimeters. Overstimulation of theca lutein cells by large amounts of HCG secreted by proliferated trophoblast;2021/5/11;Clinical manifestation; Hyperemesis gravidarum Severe nausea and vomiting Preeclampsia In the first or early second trimester, 10%-12% Pathognomonic of HM ;Ovarian theca lutein cysts Regress spontaneously several weeks after evacuation, paralleling the decline of hCG level Rupture, bleeding and infection cause acute abdominal symptoms and requires surgery Greater likelihood of developing malignant sequelae Hyperthyroidism Production of TSH by molar tissue , 10% Disappear following evacuation of the mole, an occasional patient may require antithyroid therapy ;Laboratory findings β-hCG Radioimmunoassay in serum and urine Abnormal elevated level decline to normal within 14 weeks following evacuation ;Ultrasound-----diagnostic method Reliable, safe, economical, simple, specific Characteristic pattern: multiple echoes formed by the interface between the molar villi and the surrounding tissue, no normal gestational sac or fetus;2021/5/11;2021/5/11;2021/5/11;2021/5/11;2021/5/11;2021/5/11;2021/5/11;Diagnosis and Differential diagnosis;Treatment ;2021/5/11;B. Prophylactic chemotherapy hCG 100 000U/L Patient with extremely large uterus or poor fol