Malignant gravida refers to lesions that invade the myometrium and can penetrate the uterine wall causing intra-abdominal hemorrhage and metastasize to adjacent or distant organs, such as the vagina, lungs, and brain, which can lead to the patient’s death. It has malignant tumor destructive behavior, so it is called malignant gravida, or malignant grapes for short. Its incidence accounts for 5%-20% of benign gravida. I. Risk factors Malignant gravida originates from benign gravida and mostly occurs within 6 months after gravida clearance. 1. Patients with benign staph have low immunity and the erosive ability of staph trophoblast is enhanced. 2, Nutritional deficiency. 3.Multiple pregnancies. 4, consanguineous marriage. 5.Viral infection. Abnormal manifestations 1. Vaginal bleeding is the most common symptom, manifested as continuous irregular vaginal bleeding after the clearance of benign staphyloma or bleeding again several months after the return of normal menstruation, and a few have metastatic lesions. If the primary lesion has disappeared, the symptoms of the metastatic lesion will be the main symptom, and there will be no vaginal bleeding. 2, hemoptysis after chylothorax, if there is blood in the sputum, should be highly alert to the possibility of lung metastasis. If the lesion penetrates the plasma membrane layer, it may cause local pain and pressure pain. 1. HCG measurement of benign hyperemesis HCG drops and then rises again, and does not continue to drop for 2~3 weeks, and still cannot return to normal value for 12 weeks. 2.If no blisters can be scraped or a small amount of staph tissue can be scraped out, but HCG does not drop after the operation. 3.Iodine oil hysterosalpingogram can be seen that the edge of the uterine wall is not neat and there is iodine oil penetrating into the muscle layer. 4.After the removal of staph by ultrasound, ultrasound indicates that the uterus is incompletely restored and continues to increase in size, with myometrial changes and irregular projections, suggesting the possibility of malignant staph. 5.Pulmonary X-ray examination with cough and hemoptysis symptoms can be selected to diagnose pulmonary metastases. Treatment 1.Chemotherapy can achieve the purpose of cure. 2.Surgical treatment should be performed immediately for uterine perforation, or if the lesion is confined to the uterus and chemotherapy is ineffective.