ʻO ka hāpai ʻana o Molar ma muli o kahi hanana kūpono ʻole i hanana ʻia i ka wā o ka momona a ke kumu e ulu ai ka placenta. Aia ʻelua ʻano o ka hāpai ʻana molar:

• ka hapai molar piha (a i ʻole ka mole hydatidiform piha) nā hualoaʻa mai ka momona ma waena o kahi ovum anucleated (me ka ʻole o kahi nucleus a no laila me ka ʻole o nā mea kūlohelohe) a hoʻokahi a ʻelua paha haploid spermatozoa (nona kahi kope hoʻokahi o kēlā me kēia chromosome). ʻAʻole i loko o ka huahana o kēia hāpai keiki kahi embryo akā ʻo ka placenta wale nō e ulu i ke ʻano o nā cist he nui (i kapa ʻia ʻo "grape cluster").
• hapai hapa molar (a i ʻole mole hydatidiform mole) nā hopena mai ka momona ma waena o kahi hua manu maʻamau a ʻelua spermatozoa a i ʻole kahi sperm abnormal. Aia kekahi embryo, akā ʻaʻole hiki ke ola, a ke ulu kino nei ka placenta.

I nā kūlana ʻelua ʻaʻole i loaʻa i ka hua manu nā kikoʻī piha, no laila e hoʻopau pau ʻole ka hāpai ʻana.

Hiki i ka hāpai ʻana o Molar ke hōʻike iā ia iho i nā ʻano like ʻole:

• i kona ʻano maʻamau ka hopena o ke kahe ʻana o ke kahe o ke anemia a me ka hoʻonui ʻana i ka nui o ka uterus. ʻO ka hoʻonui ʻana i nā ʻōuli o ka hāpai keiki a i ʻole toxemia o ka hāpai hāpai ʻana e ʻike ʻia i kekahi manawa. ʻO kahi ultrasound pelvic pelvic endovaginal i ukali ʻia e ke ana o ka huina serum hCG e hiki ai ke hōʻoia i ka hāpai ʻana o ka molar.
• i ke ʻano o ka hāʻawe ʻole kūlohelohe. ʻO ia ka pathology o ka huahana curettage e ʻae ai i ka ʻike ʻana i ka hāpai ʻana o molar.
• i ke ʻano asymptomat, e ʻike ʻia ka hāpai ʻana o ka molar ma ke ʻano he ma ultrasound.

Ke poʻo inoa ʻekolu paukū

He aha ke kākoʻo?

Paukū ʻekolu

Piha a piha ʻole paha, ʻaʻole hiki ke hāpai ʻia ka molar hāpai, no laila he mea pono e heʻe wikiwiki i ka huahana o ka hāpai keiki. Hana ʻia kēia e ka ʻūnana uterine i hana ʻia ma lalo o ka ultrasound control. Hana ʻia kahi anatomopathology o ka huahana o ka hāpai ʻana i mea e ʻike pono ai ke ʻano o ka mole.

Hana ʻōnaehana ʻia kahi kaha ultrasound i nā lā he 15 ma hope o ka ʻiʻini e hōʻoia i ka ʻole o ka hoʻopaʻa ʻana, kahi pilikia pinepine o ka hāpai ʻana o ka molar. I ka hanana o ka hoʻopaʻa ʻana, e hoʻokō ʻia kahi ʻiʻini ʻelua.

Ma hope o ka hemo ʻana o ka mole, nānā kiʻekiʻe ʻia ka pae o ka hCG ma ka helu o kahi hōʻike koko i kēlā me kēia pule. Pono e hoʻomau i kēia mākaʻikaʻi ma hope o ka hōʻole ʻia ʻana o ka helu (ʻo ia hoʻi he 3 mau helu maikaʻi ʻole ʻē aʻe):

• no 6 mau mahina i ka hanana o kahi mole hydatidiform hapa;
• no 12 mau mahina i ka hihia o ka mole hydatidiform piha;
• no 6 mau mahina inā, i ka hihia o ka mole hydatidiform piha, lilo ka pae hCG i mea maikaʻi ʻole ma waena o 8 mau pule (2).

Kuhi kahi pae stagant a hoʻonui hCG paha i kahi tumo trophoblastic gestational, kahi pilikia o ka hāpai ʻana o ka molar e pili ana i ka 15% o nā mole piha a me 0,5 a 5% o nā mole ʻāpana (3). Hana ʻia ka molarʻa i loko o ka uterus, hoʻonui a hoʻololi ʻia i loko o kahi pūpū tum ʻoi aku a i ʻole ka hakakā ʻole a hiki ke hoʻouka i nā paia o ka kōpū a i kekahi manawa nā lālā mamao. Kāhea ʻia kēia he mole invasive, a i ʻole choriocarcinoma. E mālama ʻia kahi māka a ma muli o nā hopena, e mālama ʻia ka chemotherapy. Kaukaʻi ʻia i ka makaʻu o ka tumo (hoʻokumu ʻia e like me ka helu FIGO 2000), kuhi ʻia ka helu hoʻōla ma waena o 80 a me 100% (4). Ma hope o ka hopena o ka mālama ʻana, koi ʻia kahi wā e nānā ai me kahi hana o ka hCG o ka mahina no 12 a 18 mau mahina.

Ke pau ka hopena o ka mole i ka hiki, hiki ke hoʻomaka i kahi hāpai hou. ʻO ka makaʻu o ka hāpai ʻana i kahi molar hou he haʻahaʻa: ma waena o 0,5 a me 1% (5).

I ka hanana o kahi tumo trophopblastic, mālama ʻole ka chemotherapy i ka momona. No laila hiki i kahi hāpai ʻē aʻe ma hope o ka pau ʻana o ka manawa nānā. Eia nō naʻe, e mālama ʻia kahi ana o ka hCG hormone ma 3 mau mahina o ka hāpai ʻana a ma hope o ka hāpai ʻana, ʻelua mau manawa i ka ʻike hou ʻia ʻana o ka maʻi.