Qi Qing-wei, Xiang Yang, Hao Na, Liu Jun-tao, Xu Yun-hua, Yang Xiu-yu, Sun Nian-hu
Department of Obstetrics and Gynecology, Chinese Academy of Medical Science, Peking Union Medical College Hospital, Beijing 100730, China.
Zhonghua Fu Chan Ke Za Zhi. 2003 Oct;38(10):595-8.
To discuss the differential diagnosis of the hydatidiform mole and a coexisting fetus, to study the prenatal diagnosis and the clinical management of a twin pregnancy consisting of a complete mole and coexisting fetus (CMCF).
Two cases of CMCF were reported retrospectively.
In the first case, the hydatidiform mole and a coexisting fetus was found by B mode ultrasound at the 10th gestational week, the patient asked to terminate the pregnancy. The interphase FISH and karyotype analysis of the normal villi and the mole showed both of them were diploid, thus the CMCF was diagnosed. In the second case, the hydatidiform mole and a coexisting fetus was found by B mode ultrasound at the 21st gestational week. Transabdominal chorionic villi sampling and amniocentesis was performed, interphase FISH and karyotype analysis of the mole and the amniotic fluid showed both of them were diploid, thus the CMCF was diagnosed prenatally. The pregnancy was continued and premature rupture of membrane happened at the 28th gestational week, the cesarean section was performed. The neonate was healthy. The karyotype analysis of the placenta and the neonate was accordant with the prenatal diagnosis.
As long as the hydatidiform mole and a coexisting fetus was found the prenatal diagnosis must be performed in order to differentiate the CMCF and the partial hydatidiform mole (PHM). The transabdominal chorionic villi sampling and the amniocentesis were ideal methods, interphase FISH and karyotype analysis of the mole and the amniotic fluid should be performed. If both of them were diploid, the CMCF could be diagnosed. The clinical management of CMCF should be done individually. If both of them were triploid, the PHM could be diagnosed.
探讨葡萄胎合并存活胎儿的鉴别诊断，研究由完全性葡萄胎合并存活胎儿（CMCF）组成的双胎妊娠的产前诊断及临床处理方法。
回顾性报道2例CMCF病例。
第1例，孕10周经B超发现葡萄胎合并存活胎儿，患者要求终止妊娠。对正常绒毛和葡萄胎进行间期荧光原位杂交（FISH）及核型分析，结果均为二倍体，诊断为CMCF。第2例，孕21周经B超发现葡萄胎合并存活胎儿。行经腹绒毛取样及羊膜腔穿刺术，对葡萄胎组织及羊水进行间期FISH及核型分析，结果均为二倍体，产前诊断为CMCF。继续妊娠，孕28周发生胎膜早破，行剖宫产术。新生儿健康。胎盘及新生儿核型分析结果与产前诊断一致。
一旦发现葡萄胎合并存活胎儿，必须进行产前诊断以鉴别CMCF和部分性葡萄胎（PHM）。经腹绒毛取样及羊膜腔穿刺术是理想的方法，应对葡萄胎组织及羊水进行间期FISH及核型分析。若二者均为二倍体，则可诊断为CMCF。CMCF的临床处理应个体化。若二者均为三倍体，则可诊断为PHM。
