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管理一例正常胎儿和雄激素性二倍体完全性葡萄胎的双绒毛膜性双胞胎妊娠。

Management of a dichorionic twin pregnancy with a normal fetus and an androgenetic diploid complete hydatidiform mole.

机构信息

Department of Obstetrics and Gynecology, Hospital Universitario Virgen de la Arrixaca, El Palmar, Spain.

出版信息

Fetal Diagn Ther. 2013;33(3):194-200. doi: 10.1159/000338926. Epub 2012 Jul 24.

Abstract

We describe a rare case of complete hydatidiform mole with twin live fetus (CHMTF) confirmed by histopathology, flow cytometry, and polymerase chain reaction techniques. No malformations were observed, fetal karyotype was normal and β-human chorionic gonadotropin levels were increased (>100,000 IU/ml). Once the patient had been informed of the risks, it was decided to continue the pregnancy, but termination of pregnancy was necessary at week 13 + 5 due to maternal complications consisting of hyperthyroidism, hypertension and vaginal bleeding, followed by persistent trophoblastic disease (PTD). Patients diagnosed with CHMTF should be informed of all known risks, including the considerable risk of PTD, which is similar to - or according to some reports - even higher than that associated with a singleton complete mole and is not increased by continuing pregnancy. Due to the low number of series published, evidence-based clinical management guidelines are lacking.

摘要

我们通过组织病理学、流式细胞术和聚合酶链反应技术描述了一例罕见的完全性葡萄胎伴双活胎(CHMTF)病例。未观察到畸形,胎儿核型正常,β-人绒毛膜促性腺激素水平升高(>100,000 IU/ml)。一旦告知患者风险,决定继续妊娠,但由于母体并发症包括甲状腺功能亢进、高血压和阴道出血,在 13 周+5 周时需要终止妊娠,随后发生持续性滋养细胞疾病(PTD)。诊断为 CHMTF 的患者应被告知所有已知风险,包括相当大的 PTD 风险,这与单胎完全性葡萄胎相似,甚至更高,并且继续妊娠不会增加风险。由于发表的系列数量较少,缺乏基于证据的临床管理指南。

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