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Mola hidatiforme - Treatment

Nombres alternativos

Mola hidatídica; Embarazo molar

Tratamiento:

Si el médico sospecha un embarazo molar, se puede llevar a cabo un legrado por succión (D y C).

Una histerectomía puede ser una opción para las mujeres mayores que no desean volver a embarazarse en el futuro.

Después del tratamiento, se vigilan los niveles séricos de la gonadotropina coriónica humana (GCH). Es importante evitar el embarazo y utilizar un anticonceptivo confiable durante 6 a 12 meses después del tratamiento para un embarazo molar. Esto permite la realización de pruebas precisas para estar seguros de que el tejido anormal no vaya a retornar. Las mujeres que quedan en embarazo demasiado pronto después de un embarazo molar tienen un mayor riesgo de tener otro.

Expectativas (pronóstico):

Más del 80% de las molas hidatiformes son benignas (no cancerosas). El pronóstico después del tratamiento es por lo general excelente y es esencial un seguimiento minucioso. Después del tratamiento, se deben usar anticonceptivos muy efectivos por lo menos de 6 a 12 meses para evitar el embarazo.

En algunos casos, las molas hidatiformes se pueden transformar en molas invasivas, las cuales pueden llegar a crecer tan profundamente en la pared uterina y provocar sangrado u otras complicaciones.

En unos pocos casos, una mola hidatiforme puede transformarse en un coriocarcinoma, una forma de enfermedad trofoblástica gestacional cancerosa y de rápido crecimiento. Ver: coriocarcinoma

Complicaciones:

Se pueden presentar problemas pulmonares después de una dilatación y legrado si el útero de la mujer es mayor al tamaño de 16 semanas de gestación.

Otras complicaciones relacionadas con la cirugía para extraer un embarazo molar abarcan:

  • Preeclampsia
  • Problemas de tiroides
  • Reviewed last on: 11/21/2010
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

Kavanagh JJ, Gershenson DM. Gestational trophoblastic disease: hydatidiform mole, nonmetastatic and metastatic gestational trophoblastic tumor: diagnosis and management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 35.

Copeland LJ, Landon MB. Malignant diseases and pregnancy. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics - Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2007:chap 45.

Goldstein DP, Berkowitz RS. Gestational trophoblastic disease. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG, eds. Abeloff’s Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 94.

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