妇产科学-2010__8年制_gtd.pptVIP

Gestational Trophoblastic Disease(GTD);Contents;Definition;Classification of GTD;Epidemiology and Risk Factors (1); Obstetric History Prior unsuccessful pregnancies Personal history of GTD Other Factors Combination oral contraceptive(COC) pill use Vitamin A and carotene deficiency Higher educational levels, smoking, irregular menstrual cycles ;Normal villi;The Karyotype of Molar Pregnancy;Hydatidiform Mole(Molar Pregnancy) ;Complete mole vs partial mole;Gross finding： Huge amount of grape-like structures No embryo components Microscopic findings： Trophoblastic proliferation Villous edema ;Gross finding： Focal molar, vary size Normal placenta tissue Identifible fetal tissues Microscopic findings： Marked villous scalloping Less trophoblastic proliferation Stromal tropboblastic inclusion ; vaginal bleeding 停经后阴道出血 (80%) excessive uterine size 子宫异常增大变软 (~30%) theca lutein ovarian cysts 卵巢黄素化囊肿 hyperemesis gravidarum 妊娠剧吐 (8%) Preeclampsia 子痫前期征象 (1:74) abdominal pain 腹痛 Hyperthyroidism 甲亢征象;Features of Complete and Partial Hydatidiform Moles;Diagnosis;; 1.子宫明显大于相应孕周 2.宫腔内“落雪状“或“蜂窝状“回声 3.子宫肌层内无或稀疏血流 4.Partial mole：可见到胎儿部分;Treatment of Hydatidiform Mole ;Follow up of Hydatidiform Mole ; 2 4 6 8 10 12 14;妊娠滋养细胞肿瘤Gestational Trophoblastic Neoplasia, GTDGestational Trophoblastic Tumor, GTT; Molar villi infiltrated into myometrium； Atypical trophoblastic proliferation； Apparent molar vesicles ; Diffuse hemorrhage and necrosis Without chorionic villi Lack of vaculazation Atypia ST, CT and IT ;Clinical Findings;Criteria for the Diagnosis of GTN;FIGO Staging;Modified WHO Prognostic Scoring System as Adapted by FIGO;Treament of GTN;Surgical management;PSTT;Follow up;Summary--1;Summary--2;Summary--3;OB/GYN Hospital of Fudan University