Pregnancy is a boon for most happiest woman. But what if the fetus is conceived not develop as expected, for example, if the pregnancy is happening apparently are pregnant wine only. Pregnant wine for a woman is like a bad dream, the hope is lost. Then, exactly what is meant by wine was pregnant?
The incident occurred in 1 pregnancy wine in 1500 pregnancies in the United States and Europe. It turned out that the number of incidents is much more common in other parts of the world such as Asia (eg in Taiwan, the incidence is about 1 out of 125 pregnancies). This emphasizes the role of race in pregnant cases of wine.
Pregnant or wine in the world of medicine known as the mola hydatidosa actually a benign tumor of the chorion villi, which can occur in women in the reproductive period. On examination, visible bubbles coming from the villi of pathological changes and contain clear fluid. Generally there is no fetus in pregnant wine events, but sometimes in cases of hydatidiform partialis / partly contained fetal amnion or at least bag. But, still, the fetus usually can not be maintained and will have a miscarriage.In the case of mola hydatidosa, female ovarian cysts can contain lutein (can be any one or on both ovaries), which will disappear by itself after a mole removed. In addition, the examination of chromosomes in these bubbles, obtained poliploidi case and almost in all cases of molar composition was the sex kromatinnya are women (46, XX).
After further investigation, it turns out the age of the mother during pregnancy has an important role as defense factors on the incidence of pregnancy wine. Known high frequency of events occurred among pregnant women wine that is in the period approaching the end of the reproductive period. Women with more than 45 years of age have the possibility of experiencing pregnancy relative to wine as much as 10x more than those who were aged 20-40 years.
The real cause of pregnancy is not known for certain wines. But there are several factors that can affect the percentage likelihood that a pregnant woman to experience the wine, among other things: frequent miscarriage, poor nutritional status, vitamin deficiency (eg vitamin A or folic acid), impaired blood circulation in the uterus.
The pregnancy's symptoms wine (in patients who amenorrhae / late period "):
1. Continuous bleeding at week 12 of pregnancy (range, could only spotty until bleeding in large amounts, often brownish color). Usually causes anemia and iron deficiency.
2. Abdominal enlargement (growth size of the uterus) is not in accordance with gestational age or earlier than usual (eg 1 month pregnant look like a pregnant 3 months).
3. Nausea and vomiting is more frequent and longer duration.
4. Incurred related high blood pressure pregnancy (if it occurs before the 24th week of pregnancy leads to wine).
5. There are no signs of the fetus (no heartbeat sound of children, order the fetus does not appear on x-rays).
6. Levels of the hormone chorionic gonadotropin (HCG) high in maternal blood and urine.
Although many symptoms that we can use to estimate the pregnancy wine, a definitive diagnosis can only be achieved after seeing the birth of the bubbles mola.
In addition to the view that there are symptoms, can also do an audit to establish the diagnosis, among others:
* X-rays: to see the framework of the baby, but if it does not look pregnant wine is not necessarily occur.
* Galli Mainini biological reactions: the quantitative measurement of gonadotropin levels.
* Experiment sonde: the pregnant wine, sonde easy entry, while in normal pregnancy, there are prisoners of the fetus.
* Injection of contrast agent into the uterus: a picture showing wasp nest.
* Ultrasound: picture shows a blizzard.
Wine or molar pregnancy hydatidosa is one cause of death in pregnant women. Deaths that occur are usually caused by:
2. perforation / hole due to the occurrence of bubbles through the uterine wall
3. infection, sepsis
4. chorion cancer (choriocarcinoma): occurs in complete hydatidiform hydatidosa which is the main cause of choriocarcinoma
Because it contains the danger of death, then pregnancy wine should be addressed. Handling of pregnant wines include 2 stages, namely abortion as soon as possible, and to supervise the possibility of the onset of symptoms chorion cancer (choriocarcinoma). Act of abortion should be done immediately so that pregnancy is not normal it did not increase in size and destroy the mother's condition. In women of childbearing age who still want the children done by curettage, whereas in women of advanced age or who already do not want children to be removal of the uterus (hysterectomy).
Abortion and curettage should be accompanied by a blood transfusion because there are likely a lot of bleeding. Then approximately 10-14 days after the first curettage, performed second curettage of the uterus which aims to produce really clean.
Women who experience hydatidosa mole may become pregnant again, but must wait until the investigation is completed supervision. For women who do not have children are encouraged to delay pregnancy for 1 year, whereas for women who already have children are encouraged to not get pregnant during the first 2 years.
Science Obstetric Pathology. Department of Obstetrics and Gynecology Faculty of Medicine, University of Padjadjaran Bandung
Williams Obstetrics, 16th Edition