Bruchim I, Kidron D, Amiel A, Altaras M, Fejgin M D
Department of Obstetrics and Gynecology, Meir Hospital, Kfar Saba, Israel.
Gynecol Oncol. 2000 Apr;77(1):197-202. doi: 10.1006/gyno.2000.5733.
The aim of this study was to report the clinical features, management, and outcome of two cases of complete hydatidiform mole with a coexisting viable fetus and to review the literature.
In this article, we report on the well-documented follow-up of 2 cases of twin pregnancies with complete hydatidiform mole and a viable fetus, both of which ended with the delivery of a normal infant at 41 and 26 weeks of gestation. It is of interest that both pregnancies were achieved following induction of ovulation with hMG/hCG. Since 1977, the year in which complete and partial moles were characterized as distinct pathologic entities, 15 cases (including our 2) have been reported.
Persistent GTT developed in eight patients (53.3%) and four patients (27.7%) developed metastatic disease. Seventy-five percent patients with persistent GTT were treated with single-agent chemotherapy. The median gestational age of the patients with subsequent persistent GTT was 34.5 weeks compared to 38 weeks in the patients without persistent GTT.
Complete hydatidiform mole and coexistent fetus is a rare occurrence and is associated with an increased risk of persistent gestational trophoblastic tumor. Based on currently available information, it seems that in the presence of a stable pregnancy, normal karyotype, and a normal sonogram it is reasonable to allow the pregnancy to continue.
本研究旨在报告两例合并存活胎儿的完全性葡萄胎的临床特征、处理方法及结局，并对相关文献进行综述。
在本文中，我们报告了2例双胎妊娠合并完全性葡萄胎及存活胎儿的详细随访情况，两例均在妊娠41周和26周时分娩出正常婴儿。有趣的是，这两例妊娠均是在使用人绝经期促性腺激素/人绒毛膜促性腺激素（hMG/hCG）诱导排卵后实现的。自1977年完全性和部分性葡萄胎被确认为不同的病理实体以来，已报告了15例（包括我们的2例）。
8例患者（53.3%）发生持续性妊娠滋养细胞肿瘤（GTT），4例患者（27.7%）发生转移性疾病。75%的持续性GTT患者接受了单药化疗。发生持续性GTT患者的中位孕周为34.5周，而未发生持续性GTT的患者为38周。
完全性葡萄胎与并存胎儿的情况罕见，且与持续性妊娠滋养细胞肿瘤风险增加相关。根据现有信息，在妊娠稳定、核型正常及超声检查正常的情况下，允许妊娠继续似乎是合理的。
