Chorionadenoma (molar pregnancy)

What is chorionadenoma?

Chorionadenoma is an irregular formation of the placenta, which is formed only from a set of three chromosomes of the father, while the mother's chromosomes are absent. Formation of the embryo does not occur, but skidding (intrauterine growth) provokes the symptoms of pregnancy. According to statistics, one in a thousand women with symptoms of pregnancy are diagnosed with chorionadenoma. There are two types of chorionadenoma: complete and incomplete.

• Full chorionadenoma. In place of the common placenta and embryo, a skid is formed, which can fill the uterus.
• Incomplete chorionadenoma. The placenta is formed incorrectly and grows into a skid. Any formation of fetal tissue has severe defects.

In rare cases, with a two-plaited pregnancy, one placenta and fetus develop normally, and the other - has abnormalities and is diagnosed as a chorionadenoma.

Risk factors for chorionadenoma

Chorionadenoma provokes severe uterine bleeding and in some cases leads to an abnormality of cell division, known as a trophoblastic tumor.

• In 15-20% of cases of complete chorionadenoma after its extraction a trophoblastic tumor develops, which sometimes becomes an invasive cancer. Fortunately, it is treatable.
• In 5% of cases, incomplete chirionadenoma passes into a trophoblastic tumor.

Rarely pathological tissue gives metastases to other parts of the body.

Causes of Chorionadenoma

It is believed that the chorionadenoma is the result of a genetic mutation of the egg or sperm. It develops in the early stages of pregnancy, when:

• the egg is fertilized without genetic information (loss of maternal genes), sperm chromosomes are duplicated, and a skid (single-parent dysomia) is formed;
• one healthy egg is fertilized with two spermatozoa (dispersion).

Risk factors

• age: after 35 years, the risk of developing chorionadenoma increases;
• history of previous hirionadenoma (especially if there were several);
• history of previous miscarriage;
• deficiency of vitamin A.

Symptoms of chorionadenoma

Chorionadenoma provokes symptoms of normal pregnancy (absence of menstrual cycle, breast engorgement, fatigue, frequent urination, morning sickness) and is diagnosed with ultrasound at an early stage. In addition, the chorionadenoma provokes other symptoms:

• vaginal secretion of tissue, which has the form of grapes (a characteristic sign of the chorionadenoma);
• vaginal bleeding (minor or severe);
• too much uterine enlargement for early pregnancy;
• severe nausea and vomiting;
• signs of hyperthyroidism: fatigue, weight loss, palpitations, sweating, irritability, anxiety, muscle weakness and enlargement of the thyroid gland.

But most of these symptoms can also testify to multiple births, miscarriages and even quite normal pregnancies.

Diagnosis of chorionadenoma

If you have symptoms of chorionadenoma, the doctor will do an examination, prescribe a blood test to determine the pregnancy hormone and ultrasound. Chorionadenoma is also diagnosed at an early stage of pregnancy during a planned ultrasound or during treatment of an incomplete miscarriage.

Treatment of chorionadenoma

If you were diagnosed with "chorionadenoma," you should immediately treat and remove the intrauterine proliferation. After cleaning the uterus should periodically take tests (once or twice a year) for the presence of trophoblastic tumors. In some women, along with the chorionadenoma, the ovarian cyst develops (benign).

Sometimes a trophoblastic tumor passes into a cancer that can be detected at an early stage only in the uterus and can be treated with chemotherapy. In cases of metastasis to other parts of the body, treatment involves chemotherapy and radiation.

Most women who have undergone treatment for trophoblastic disease have a chance to have a baby. With chorioinadenoma, women are depressed and fear development of cancer. Contact the support group, talk with friends or with a psychologist.

Chorionadenoma: Symptoms

Chorionadenoma provokes symptoms of pregnancy - lack of a menstrual cycle, tenderness of the mammary glands, fatigue, frequent urination and nausea in the morning.

Contact the doctor immediately if you have signs of pregnancy and observe the following symptoms:

• vaginal secretion of tissue in the form of grapes (a characteristic symptom of chorionadenoma);
• vaginal bleeding: minor bleeding in the first trimester is common and with a healthy pregnancy, but it can also indicate a chorionadenoma and miscarriage;
• severe nausea and vomiting (sometimes such symptoms occur in case of chorionadenoma);
• signs of hyperthyroidism: fatigue, weight loss, palpitations, sensitivity to heat, muscle weakness and enlargement of the thyroid gland.

Symptoms of a choroidadenoma:

• high blood pressure, which is a sign of pre-eclampsia;
• absence of palpitation of the fetus, since it is absent in both complete and partial chorionadenoma;
• uncharacteristic sizes of the uterus for gestational age: a large increase in the uterus can be only in a few cases - with chorionadenoma, multiple pregnancies or when the woman herself does not know the period of her pregnancy.

Now chorionadenoma is diagnosed at an early stage of pregnancy with the help of ultrasound. Therefore, in very rare cases, it provokes excessive uterine enlargement, nausea, vomiting, late toxicosis and symptoms of thyroid hyperfunction.

Chorionadenoma: Diagnosis and Tests

In most cases, it is possible to diagnose the chorionadenoma at an early stage, so at the first signs you need to visit a doctor who will prescribe simple tests and will make an examination, including:

• gynecological examination to determine the size of the uterus and to identify pathology;
• a blood test to detect the amount of a pregnancy hormone (human chorionic gonadotropin);
• Ultrasound to confirm the diagnosis (often the chorionadenoma is diagnosed during an ultrasound examination assigned for a different purpose).

In the case of diagnosing chorionadenoma, the doctor prescribes additional blood and urine tests and chest x-ray to identify:

• preeclampsia
• anemia
• cancer cells
• hyperthyroidism caused by a chorionadenoma.

Chorionadenoma: Treatment Overview

Chorionadenoma is removed by vacuum aspiration under general anesthesia. The doctor simultaneously uses ultrasound to completely remove the pathological tissue. Before and after the procedure, oxytocin is prescribed to reduce the uterus and return it to its normal size, and also to stop bleeding after surgery. If the Rh factor is negative, it is necessary to inoculate Rh-antibodies to prevent future problems. If in the future you do not plan to have a baby, you can think about removing the uterus, which reduces the risk of trophoblastic tumors after chorionadenoma.

If you are at risk for developing cancer after chorionadenoma, you can prevent the growth of cells with a medical drug - methotrexate.

In rare cases, along with the coryonadema in the uterus, a healthy fetus can also develop.

Follow-up rehabilitation

After the removal of the chorionadenoma, you should visit the doctor regularly to identify cancerous tumors at an early stage. It should be noted that:

• every two weeks to take a blood test for the level of human chorionic gonadotropin until the results are in accordance with the norm (high levels of hormones indicate the presence of cancer cells);
• take contraceptives while monitoring the level of the hormone (human chorionic gonadotropin), which usually lasts 6 months.

Trophoblastic tumor

In most cases, the trophoblastic tumor grows only in the uterine cavity. If you are diagnosed with this diagnosis or you are at risk for developing it, you will probably be prescribed one or more medications (methotrexate or actinomycin D). But if metastases are found in other organs of the body, chemotherapy is used.

Fertility and rehabilitation after chorionadenoma

After the removal of chorionadenoma, the chances of a healthy pregnancy are the same as in most women even after a course of treatment for a trophoblastic tumor. But, nevertheless, there is an increased risk of repeated chorionadenoma. Therefore, you will be under the supervision of a doctor before and after pregnancy. Observation implies:

• Observation of a pregnant woman and ultrasound at the end of the first trimester to confirm a healthy pregnancy;
• a blood test for the level of the hormone (human chorionic gonadotropin) at 6 weeks after the birth of the child in order to exclude the development of a trophoblastic tumor.

Chorionadenoma affects the emotional and physical state of a woman. The bitterness of pregnancy loss combined with the fear of development of cancer is difficult to bear. In this case, it is necessary to enlist the support of friends, family members, and a psychologist to overcome this difficult period.

Chorionadenoma: Treatment at home

Chorionadenoma can not be treated at home. Once it is removed, effective contraceptives should be taken to prevent pregnancy.

[1], [2], [3], [4], [5]