Marcorelles Pascale, Audrezet Marie-Pierre, Le Bris Marie-Josée, Laurent Yves, Chabaud Jean-Jacques, Ferec Claude, de Braekeleer Marc, Collet Michel, Lagarde Nicole
Service d'Anatomie Pathologique, CHU Morvan, 5 Avenue Foch, 29609 Brest Cedex, France.
Eur J Obstet Gynecol Reprod Biol. 2005 Jan 10;118(1):21-7. doi: 10.1016/j.ejogrb.2004.02.042.
The aim of this study was to highlight the outcome of complete hydatidiform mole (CHM) coexisting with a live co-twin.
We investigated four cases of such pregnancy by ultrasound, pathological, cytogenetic, and molecular techniques. Information on clinical follow-up and outcome was also available.
All four pregnancies were spontaneous: two ended with the delivery of a live-born baby, while the other two were terminated because of signs of serious maternal pathology or intrauterine fetal death. The criteria for carrying on with the pregnancy are reviewed. The immediate outcome depends on the maternal criteria of serious pathology and on the likelihood of intrauterine fetal death. The risk of persistent trophoblastic disease (PTD) is the same as in the case of a singleton complete mole and also seems to be correlated with the zygosity mechanism identified by molecular analysis.
Hydatiform mole with a live co-twin fetus is a rare obstetric occurrence. In the case of a normal fetal karyotype, it is justifiable to await developments in the absence of maternal complications. However, treatment criteria still need improvement and diligent maternal follow-up is always warranted in the postpartum period.
本研究旨在突出完全性葡萄胎（CHM）与存活的双胎之一共存的结局。
我们通过超声、病理、细胞遗传学和分子技术对4例此类妊娠进行了研究。还获得了临床随访和结局的信息。
所有4例妊娠均为自然妊娠：2例以活产婴儿分娩告终，另外2例因严重母体病理体征或宫内胎儿死亡而终止妊娠。对继续妊娠的标准进行了回顾。直接结局取决于严重病理的母体标准以及宫内胎儿死亡的可能性。持续性滋养细胞疾病（PTD）的风险与单胎完全性葡萄胎的情况相同，并且似乎也与分子分析确定的合子机制相关。
葡萄胎与存活的双胎胎儿共存是一种罕见的产科情况。在胎儿核型正常的情况下，在无母体并发症的情况下等待病情发展是合理的。然而，治疗标准仍需改进，产后始终需要对母体进行密切随访。
