Find what if gynecological tumour at the time of pregnancy

Find what if gynecological tumour at the time of pregnancy
Harbin medical university attaches to the gynaecology and obstetrics of the first hospital Zheng JianHua Jiang LiYu
Diagnosis and treatment of tumour are clinical difficult points in pregnancy period, need to give consideration to pregnant woman, foetus, three respect factors of tumour. So check before pay attention to pregnant, find pathological change, deal with, avoid, bring tumour gestation very much important in time in time when being pregnant.
Amalgamate benign tumour Observe closely
Amalgamate ovarian tumour Judge properties as first
It is relatively common that ovarian cyst amalgamates gestation, with ripe bag monster and tumour and slurry (or mucus) Bag adenoma is in the majority, accounts for 90% that gestation amalgamated the ovarian tumour. Except for complication, does not generally have obvious symptom, often find while checking in Ultrasonography B. Gestation amalgamates ovarian tumour to endanger big than not pregnancy period: Tumour imbeds the pelvis might be caused and miscarried when being pregnant early, it is apt to erupt the base of a fruit simultaneously to turn back at the time of gestation in middle period, at the time of gestation if tumour can relatively cause the position of a foetus to be unusual in later period, can cause tumour to break while giving a birth, if the intersection of tumour and position can obstruct while being low birth canal lead to the fact and have difficult labour.
Find ovarian tumour in gestational period, should define the properties of tumour at first. The single side, single room, diameter pregnanting and discovering in early days 10cm) , have peritoneum stimulate symptom,etc., too should consider skin tumour reject.
Amalgamate malignant tumour Guard against and misdiagnose
It is the most common gynecological malignant tumour of pregnant amalgamation that gestation amalgamates cervical cancer, secondly it is the gestation that amalgamates ovarian cancer, gestation and amalgamates vulva cancer.
Amalgamate cervical cancer Diagnose it must be cautious
The vagina appears gestational period to bleed or arrange the liquid, after getting rid of the bleeding that the factor of obstetrical department causes, should make detailed gynaecology to check, should do the palace neck and shave one, vaginal mirror and check to suspicious pathological change of the palace neck, the neck of temporary dwelling place lives and examines diagnosing clearly under the guidance of vaginal mirror if necessary.
The gravidic palace neck scale - column connection site is influenced by high estrogen to move outside, basal cells increase life to jump, can appear similar the intersection of normal position and the intersection of cancer and pathological change, it loss cell, can have cores increase, dye etc., display deeply, cytologic to check and find abnormality, but can return to normal in postpartum 6 weeks, does not need to deal with. So diagnose in pregnancy period cervical cancer should be cautious, guard against and misdiagnose.
The suspicious palace neck soaks cancer but not has enough evidence verifier in gestational period, can continue gestation, reexamine in 6~12 weeks after giving a birth. To the person who makes a definite diagnosis of cervical cancer, should leave according to the cervical cancer one and pregnant time limit, adopt the surgery or radiotherapy. Still select surgery for use to treat for early pathological change in principle, middle and adopting radiotherapy or putting synchronously, chemotherapy according to the histologic type in later period. Gestation is early, relies mainly on treating parent's cancerous swelling in time in middle period, and gestation can delay treating 24 weeks later, walk and cut open the palace to produce in 32~34 pregnant weeks, and then treat cervical cancer. It is generally acknowledged to diagnose 20 weeks after gestation, the person who limited toes little focus of the palace neck of pathological change, if demand to continue gestation urgently, can delay until the foetus ripely. Give birth to the way in order to cut open the palace and produces, do while cutting open the palace and producing according to the condition the whole uterus is excised or the extensive uterus is excised.
On clinic, pathological change before cancer of cervical cancer - -Cover inner tumour is turned into (cin) on the palace neck Amalgamate with gestation relatively amalgamation common cervical cancer of gestation far. Because gestation amalgamate the intersection of cin and progress for mirror and naked eye it soaks the danger of cancer to be relatively little, the proportion disappearing naturally postpartum is high, so to cin , cin Person can wouldn't treat, observe until 6 postpartum by week; cin Person should count week according to gestation, it more make about foetus' intensities urgent to require at patient, needn't stop gestation in principle, but need to examine closely at the same time. It is 6~8 weeks postpartum, if cytologic checks and lives and examines and proves normal position cancer, the neck awl of feasible palace is cut or the whole uterus is excised.
Amalgamate ovarian cancer and vulva cancer Treat actively as soon as possible
Gestation amalgamates ovarian malignant tumour in recent years the morbidity rises to some extent, this may increase and urge to ovulate with childbearing age the treatment is concerned certainly. Different from having in gestational period in treatment, take operation as the core, complement it by chemotherapy. Highly suspect pelvis lump of the ovarian malignant tumour and should perform the operation as soon as possible, diagnose clearly. Excise behind the tumour analysing and observing and checking icy pathology immediately in the skill, such as making a definite diagnosis of for being malignant, does counting, patient's will decide want according to tumour invading and the range, gestation week
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