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[足月妊娠时与绒毛膜癌相关的大量胎儿-母体出血]

[Massive fetal-maternal hemorrhage at term associated with a choriocarcinoma].

作者信息

Theunissen I, Gosseye S, Van Lierde M

机构信息

Unité d'Obstétrique, Université de Louvain, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1992;21(1):109-11.

PMID:1374089
Abstract

A case of malignant choriocarcinoma produced a major feto-maternal transfusion at term. This was proven using routine Kleihauer's test. The newborn died on the 5th day of life from haemorrhagic shock. The diagnosis of choriocarcinoma was made when acute post-partum haemorrhage occurred together with a high level of Beta HCG. The patient was cured by the use of Methotrexate followed by four courses of tri-chemotherapy (Methotrexate, Actinomycin and Cyclophosphamide). After treatment for secondary infertility, the patient had two normal pregnancies. This case makes possible to point out again the possible association of a positive Kleihauer test with choriocarcinoma. It also points out strongly the value of carrying out Beta HCG testing when bleeding occurs post-partum. Early diagnosis improves the maternal prognosis and allows conservative treatment to be carried out in cases of choriocarcinoma in young women.

摘要

一例恶性绒毛膜癌在足月时发生了大量母胎输血。这通过常规的克莱豪尔试验得到证实。新生儿在出生后第5天死于失血性休克。当产后急性出血伴有高水平的β-HCG时,作出了绒毛膜癌的诊断。患者通过使用甲氨蝶呤治疗,随后进行了四个疗程的三联化疗(甲氨蝶呤、放线菌素和环磷酰胺)而治愈。在治疗继发性不孕后,患者有两次正常妊娠。该病例再次指出了克莱豪尔试验阳性与绒毛膜癌之间可能存在的关联。它还强烈指出了产后出血时进行β-HCG检测的价值。早期诊断可改善母亲的预后,并允许对年轻女性绒毛膜癌病例进行保守治疗。

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