Methods of Traditional Chinese Medicine for Treating Malignant Hydatidiform Mole

For unmarried female friends, seeing hydatidiform mole will definitely feel very strange. Is this also a type of fetus? Today I will introduce to you the concept of hydatidiform mole and its treatment methods, especially how our traditional Chinese medicine should deal with malignant hydatidiform mole. We know that two weeks after pregnancy, the fetal heartbeat will appear, and with the help of external tools we can hear the baby's heartbeat. There is no fetal heartbeat in a hydatidiform mole, and only the murmur of the blood vessels in the uterus can be heard.

Hydatidiform mole is a condition in which the microvessels in the villous matrix disappear, resulting in accumulation of fluid in the villous matrix and formation of bubbles of varying sizes that resemble grapes. There are complete and partial hydatidiform moles, and most of them are complete hydatidiform moles. The clinical diagnosis of hydatidiform mole refers to complete hydatidiform mole; partial hydatidiform mole accompanied by placental tissue and/or fetus is called partial hydatidiform mole. In the tissues of spontaneous abortion, 40% of patients were found to have certain vesicular degeneration, but they were not diagnosed as hydatidiform mole.

1. Drug treatment:

Inducing labor by intramuscular injection of Trichosanthes kirilowii: It is rarely used nowadays. A skin test should be done before using the medicine and it should be used as usual. It is prohibited for patients with liver or kidney dysfunction and heart disease. Radix Trichosanthis is a ribosome-inactivating protein extracted from the root of the traditional Chinese medicine Trichosanthes kirilowii. It can specifically kill syncytial trophoblast cells, causing trophoblast cell death and necrosis, leading to embryonic death. It is made into an injection and used to induce labor in early and mid-pregnancy.

Usage and Dosage: For intramuscular injection, dilute 1.2 mg of Trichosanthes protein crystals with 4 ml of normal saline and inject into the buttocks muscle (do not perform deep muscle injection). At the same time, dexamethasone 5 mg was injected intramuscularly twice a day for 2 days.

2. Surgical treatment:

1. Uterine curettage: Because hydatidiform mole may cause heavy bleeding at any time, the contents of the uterus should be removed in time after the diagnosis is confirmed, usually by suction uterine curettage. During the process of sucking out the contents, the uterus gradually shrinks and hardens. Although the aspirated material contains a large amount of blood, most of it is the original blood accumulation in the uterine cavity, so the patient's pulse and blood pressure generally do not change much. If hysterectomy is necessary, it can be performed immediately after uterine aspiration. Cesarean section to remove hydatidiform mole may lead to implantation and metastasis of hydatidiform mole. If there is no suction equipment, the hydatidiform mole can be clamped after dilating the cervix.

The first uterine curettage does not need to be too complete, so as not to damage the softer uterine wall. A second curettage can be performed in about a week.

Often, patients who still have uterine bleeding after uterine curettage and seek medical treatment can be treated according to the current situation. If incomplete abortion of hydatidiform mole is suspected (incomplete suction curettage or new blister-like substances are produced), a complete curettage can be performed cautiously. If bleeding persists, the lesion should be considered to have invaded the uterine wall. For details, see malignant hydatidiform mole and choriocarcinoma. Patients with spontaneous abortion due to hydatidiform mole should also undergo uterine curettage. There are different opinions on whether to administer uterine contraction drugs intravenously during uterine curettage. Therefore, during the operation, if the uterus contracts well, there is no need to routinely use uterotonics. They should only be used when there is heavy bleeding and poor uterine contraction.

3. Women who are over 40 years old or have given birth and whose uterus grows rapidly should be advised to have a hysterectomy. Young women can consider retaining their ovaries.

4. Other therapies:

1. Patients with severe anemia should be given small amounts of blood transfusions repeatedly and slowly, and the patient should be closely observed for active bleeding. Curettage should be performed only after the condition improves to a certain extent. In case of active bleeding, blood transfusion should be given at the same time as uterine cleaning.

2. Correct electrolyte imbalance. People with long-term bleeding and loss of appetite often have dehydration and electrolyte imbalance, which should be checked and corrected.

3. Control infection: Long-term uterine bleeding or repeated unclean operations can easily cause infection, which can manifest as local (uterine or adnexal) infection or sepsis. Adequate anti-inflammatory drugs should be given, and anemia and electrolyte imbalance should be actively corrected.

In order to avoid the symptoms of hydatidiform mole during pregnancy, pregnant mothers must take care of their bodies, develop good eating habits, and terminate the pregnancy if necessary. This is not only responsible for their own health, but also for the unborn baby. Nowadays, mothers go to the hospital for regular prenatal checkups during pregnancy, so there won’t be any major problems and we just need to be a little careful.