Precautions after the second uterine curettage

Secondary uterine curettage can cause great harm to your health. Generally, it is not recommended for girls to have an abortion. Girls must protect themselves well and should only consider pregnancy if they are sure that they have the ability to raise a child. If they do not have the ability to raise a child, they should take protective measures. If a second uterine curettage is necessary for some special reasons, it is also necessary for people to understand some precautions after the curettage. Here are some things to note after the second uterine cleaning.

Precautions after the second uterine curettage of hydatidiform mole

A hydatidiform mole is an abnormal pregnancy that fails to develop into an embryo. It is caused by the hyperplasia of the villous epithelium of the placenta, in which the interstitial degeneration and edema become countless blisters of varying sizes, which look like bunches of grapes and are named after them. They are also called vesicular fetal masses. Because a normal embryo has only one bunch of placental villi, if cotton-like villi are found in the aspirated material after the abortion, it can be determined that all the embryos have been removed. Hydatidiform mole has countless blisters, and it is difficult to clean out the contents in one go. Moreover, cleaning the uterine contents for too long will increase intraoperative bleeding, which is not good for the patient. Therefore, most gynecologists advocate sucking out most of the contents the first time, and then performing curettage after a week when the uterus has contracted to make the uterine cavity smaller and the uterine wall tighter.

Once a hydatidiform mole is diagnosed, uterine evacuation should be performed immediately. Electric suction curettage is generally used, and it can be scraped again after one week. Preparations for blood transfusion should be made before the operation, and care should be taken to prevent uterine perforation during the operation. To prevent infection, antibiotics are used before and after surgery. So, what are the precautions after the second uterine curettage of hydatidiform mole?

Prevention of malignant transformation: prophylactic hysterectomy. It is not widely used at present. However, it can also be considered for those who are older and have no desire to have children.

Preventive chemotherapy: Preventive chemotherapy is an effective means to prevent malignant transformation of hydatidiform mole. The chemotherapy criteria are as follows: (1) age over 40 years old; (2) trophoblastic cells highly proliferate or have anaplasia; (3) the grape tissue scraped out is mainly small grapes; (4) hCG does not decrease continuously or increases after decreasing; (5) there are no follow-up conditions.

Follow-up: Check hCG once a week after the hydatidiform mole is expelled, and once every 1-2 months after a negative result. Check once every 6 months in the second year for at least two years. Take chest X-rays regularly while checking hCG. To avoid a second hydatidiform mole or malignant transformation, patients should be advised to adhere to contraception for 1 to 2 years.

How is hydatidiform mole formed?

Hydatidiform mole is also called hydatidiform mole. Hydatidiform mole is caused by the proliferation of trophoblastic cells of the placenta villi and interstitial edema after pregnancy, which forms blisters of varying sizes. The blisters are connected by pedicles to form a cluster, which is named after its shape like grapes. The exact cause of hydatidiform mole is still unclear. It is generally believed to be related to nutritional disorders (especially folic acid deficiency), infection (especially viral infection), genetics and immune dysfunction.

After pregnancy, the embryo produces many villi and implants them in the mother's uterus. The fetus relies on these large numbers of villi to exchange substances with the mother, obtain oxygen, nutrition and carry out metabolism. Under pathological conditions, due to edema of the villous interstitium, it contains a large amount of transparent serous fluid, which makes the volume extremely swollen, and each villus becomes an enlarged blister. The diameter is generally 0.2~0.5 cm, and some are even larger. These blisters are connected in clusters, resembling grapes, of different sizes, with thin and transparent blister walls, containing viscous fluid, and the blisters are filled with blood and blood clots.

Women with hydatidiform mole usually have obvious pregnancy reactions in the early stages of the disease, especially women over 40 years old. They experience amenorrhea after taking contraceptive measures, and soon after the amenorrhea, they have severe nausea, vomiting, anorexia and other symptoms, or they develop symptoms of pregnancy poisoning such as hypertension, edema, and proteinuria at an early stage. Therefore, when women, especially middle-aged women, have menopause and experience obvious pregnancy reactions or early onset of preeclampsia, they should suspect the possibility of hydatidiform mole and go to the hospital for examination.