Abnormal manifestations of benign staphyloma and prevention

  Benign staphyloma is caused by the degeneration of trophoblast cells in the outer layer of the embryo, and the chorionic villi become edematous and form bunches of blister-like objects like grapes, hence the name. The incidence of benign hyperemesis is 285.9/100,000 in China and can occur at any stage of reproductive age, with a much higher incidence in older pregnant women over 40 years of age. It is believed that the chance of occurrence of gravida in another pregnancy after one gravida is higher than that of the average pregnant woman.  The early death of the embryo occurs before the establishment of blood circulation, and the chorion is nourished by the mother and continues to survive.  2, Chromosomal abnormalities may be associated with degenerative changes in the egg or poor internal environment of the uterus.  3, Viral infection may be caused by viral infection of the spermatozoa.  4, Nucleus imbalance theory (i.e., fertilization of empty eggs) loss of chromosomal activity in the nucleus of the mother egg at the time of fertilization.  5. Nutritional theory may be related to malnutrition.  Abnormal manifestations 1. Vaginal bleeding Most of these patients start to have repeated vaginal bleeding 2~3 months after amenorrhea, the amount of bleeding may be more or less, with or without, repeatedly. It is coffee-colored mucus-like or dark red blood-like, and the treatment of birth control is ineffective. The gravida can be expelled by itself, but if there is a lot of bleeding before expulsion, the patient may go into shock or even die if not treated timely, and small blisters can be seen in the expelled blood.  2, pregnancy vomiting and gestational toxicity because the proliferating trophoblast cells produce a large amount of HCG, so these patients vomit more than normal pregnancy; and because of the rapid growth of the gravida, the uterus grows fast, intrauterine tension, so that gestational toxicity can occur in the early stages of pregnancy, and even acute heart failure or eclampsia.  3, rapid growth of the uterus caused by rapid growth of the gravida and intrauterine bleeding, more than half of the uterus is significantly larger than the month of menopause.  4, ovarian cysts in patients with staphylocysts due to the stimulation of a large number of HCG caused by bilateral or one side of the ovary with multiple cyst changes, 1 to 3 months after the expulsion of staphylocysts as late as 6 months cysts naturally disappeared, no impact on the future function of the ovary.  5. Cough and hemoptysis manifested as cough, hemoptysis or blood in sputum, which may be caused by the transfer of wandering trophoblast cells from the chorion to the lung.  6. Hyperthyroidism accounts for 10% of cases. Due to the proliferation of trophoblast cells producing large amounts of chorionic gonadotropin and chorionic thyroid hormone, thyroid function increases, and the symptoms disappear rapidly after the clearance of the gravida.  1. Ultrasound is usually diagnostic at about 10 weeks of gestation, or 8 weeks if a vaginal probe is used.  2.Chorionic gonadotropin (HCG) measurement When the serum HCG is more than 200,000 U/L and lasts for a long time, it indicates the possibility of staphylocytosis.  Treatment 1. Once the diagnosis is confirmed, the uterus should be cleared in time.  2.Total hysterectomy is feasible for those who are over 40 years old, with rapid uterine enlargement and malignant tendency, and have no requirement for reproduction.  3.Prophylactic chemotherapy should be given to those who are above 40 years old, with uterus significantly larger than the month of menopause, high and long duration of HCG in urine, with hemoptysis and other malignant tendency. 5.Complications and prevention 1.Hemorrhage should be examined in time to confirm the diagnosis and remove the gravida in time.  2. To prevent perforation, oxytocin is usually administered intravenously before aspiration to make the uterus contract and the uterine wall thicken. The first clearance should not be too much, and if there is suspected residual, the second clearance should be given after 1 week.  3. Infection is usually treated with antibacterial therapy for two or three days before surgery to prevent infection.  4.Extensive pulmonary embolism is caused by a large number of blisters entering the vein through the right heart into the pulmonary artery and can even be immediately fatal.  5.Malignant transformation accounts for 10%~20%. Prophylactic chemotherapy is performed for those with malignant tendency.  Recovery 1. HCG check: after the clearance of staph patients, blood and urine should be checked once a week, and after normalization, blood and urine should be checked once a month, and after 3 months, urine should be checked once a month, and after that, it should be rechecked once every 6 months, at least for 2 years.  2.Patients who have vaginal bleeding or hemoptysis after the clearance of staphyloma should be rechecked immediately.  3.Check the pelvis or take chest X-ray on time.  4.Tendency of deterioration: HCG is still higher than normal 3 months after the clearance of staph, and it starts to drop and then rises again soon after the clearance. All the above conditions prove that there is a tendency of malignant change and should receive chemotherapy in time. The malignant change after gravida mostly occurs within 1 year, but there are also those who are more than 10 years old. Pregnancy and delivery cannot reduce the possibility of malignant change of gravida.  5. Pregnancy: contraception should be used for 1 year after gravida, and pregnancy should be terminated within 1 year without fear.  7. Preventive health care 1. Implement eugenic measures and avoid high maternal age.  2. Have fewer and better babies and avoid multiple pregnancies.  3. Pay attention to health care in the pre-pregnancy period, maintain a good physical and mental state, and have a comprehensive diet.