Sebire Neil J, Foskett Marianne, Paradinas Fernando J, Fisher Rosemary A, Francis Ros J, Short Delia, Newlands Edward S, Seckl Michael J
Trophoblastic Disease Unit, Department of Histopathology, Imperial College School of Medicine at Charing Cross Hospital, London W6 8RF, UK.
Lancet. 2002 Jun 22;359(9324):2165-6. doi: 10.1016/S0140-6736(02)09085-2.
We assessed 77 twin pregnancies, comprising complete hydatidiform mole (CHM) and healthy co-twin, to ascertain the risks to the mother and baby of continuing the pregnancy, versus termination. 24 women with histologically confirmed CHM and healthy co-twin pregnancies decided to have a termination. 53 women continued with their pregnancies, though two had to have terminations because of severe pre-eclampsia, and 23 spontaneously aborted (<24 weeks' gestation). 28 pregnancies lasted 24 weeks or more, resulting in 20 livebirths. Chemotherapy to eliminate persistent gestational trophoblastic disease (pGTD) was required in three of 19 women (16%; 95% CI 3-39) who terminated their pregnancies in the first trimester, and in 12 of 58 (21%; 95% CI 11-33%) who continued their pregnancies. CHM and healthy co-twin pregnancies have a high risk of spontaneous abortion, but about 40% result in livebirths, without significantly increasing the risk of pGTD.
我们评估了77例双胎妊娠，其中包括完全性葡萄胎（CHM）及健康的双胎之一，以确定继续妊娠与终止妊娠对母婴的风险。24例经组织学确诊为CHM且双胎妊娠中另一胎儿健康的孕妇决定终止妊娠。53例孕妇继续妊娠，不过有2例因重度子痫前期而不得不终止妊娠，还有23例自然流产（妊娠<24周）。28例妊娠持续24周或更长时间，最终有20例活产。在妊娠早期终止妊娠的19例孕妇中有3例（16%；95%CI 3-39）需要化疗以消除持续性妊娠滋养细胞疾病（pGTD），在继续妊娠的58例孕妇中有12例（21%；95%CI 11-33%）需要化疗。CHM与健康双胎之一的妊娠有很高的自然流产风险，但约40%的妊娠可导致活产，且不会显著增加pGTD的风险。
