Unsal M A, Guven S
Department of Obstetrics and Gynecology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Clin Exp Obstet Gynecol. 2012;39(2):262-4.
The co-existence of a hydatidiform mole with a living fetus is a rare phenomenon. The condition is a dilemma with respect to the diagnosis and management of associated maternal (a risk of maternal complications, such as preeclampsia, hyperthyrodism, and a risk of malignancy) and fetal (elevated risk of spontaneous abortion, neonatal thyrotoxicosis) complications. A 27-year-old woman was referred to our hospital with a diagnosis of hydatidiform mole and live fetus. The pregnancy was unremarkable except for the complaints of excessive nausea and vomiting. Successive ultrasound examinations demonstrated a normally growing live fetus (14 weeks) alongside a normal placenta and an additional intrauterine echogenic mass with features of hydatidiform mole. Genetic amniocentesis at 18 weeks' of gestation showed normal diploid fetal karyotype. At 20 weeks of pregnancy, a control prenatal visit revealed intrauterine fetal death. The follow-up period for two years was unremarkable. In the case of a normal fetal karyotype and the absence of serious signs of maternal pathology, waiting until fetal viability is achieved can justifiably be proposed, however there is still a risk of prenatal complications such as intrauterine death.
葡萄胎与存活胎儿并存是一种罕见现象。就相关母体并发症（如先兆子痫、甲状腺功能亢进以及恶变风险）和胎儿并发症（自然流产风险增加、新生儿甲状腺毒症）的诊断与管理而言，这种情况是一个难题。一名27岁女性因诊断为葡萄胎和存活胎儿被转诊至我院。除了严重的恶心和呕吐主诉外，此次妊娠并无异常。连续超声检查显示一个正常生长的存活胎儿（14周），伴有正常胎盘，以及一个具有葡萄胎特征的额外子宫内回声团块。妊娠18周时进行的基因羊膜穿刺术显示胎儿核型为正常二倍体。妊娠20周时，一次常规产前检查发现宫内胎儿死亡。两年的随访期并无异常。在胎儿核型正常且无严重母体病理体征的情况下，可以合理地建议等待至胎儿具备存活能力，但仍存在产前并发症如宫内死亡的风险。
