Ferraz Tiago José Santos de Matos, Bartosch Carla Maria Magno, Ramalho Carla Maria Almeida, Carvalho Filipa Abreu Gomes de, Carvalho Berta Cecília Campos Lima de, Brandão Otília Gonçalves Bento Cavaleiro, Montenegro Nuno Aires Mota Mendonça
Serviço de Ginecologia e Obstetrícia, Centro Hospitalar de São João do Porto, Portugal.
Rev Bras Ginecol Obstet. 2013 Jan;35(1):39-43. doi: 10.1590/s0100-72032013000100008.
A dichorionic twin pregnancy with complete hydatidiform mole and coexistent fetus is a rare and challenging situation, whose pathogenesis has not been yet fully understood. We present a case of a 39-year-old woman who underwent intracytoplasmic sperm injection with two embryos transfer. The 12-week gestation ultrasound examination revealed normal fetus and placenta with features of hydatidiform mole, leading to pregnancy termination. Autopsy and histological examinations diagnosed a complete mole coexisting with a normal fetus, and the genetic analysis showed a diploid fetus with biparental genome and molar tissue with paternal diploidy. This case highlighted that complete molar pregnancies may still occur even though pregnancy is achieved after intracytoplasmic sperm injection. A review of the literature was performed by collecting data from the few similar reported cases and by commenting on the pathogenesis of this rare condition.
双绒毛膜双胎妊娠合并完全性葡萄胎及共存胎儿是一种罕见且具有挑战性的情况,其发病机制尚未完全明确。我们报告一例39岁女性,她接受了卵胞浆内单精子注射并移植了两个胚胎。孕12周超声检查显示胎儿和胎盘正常,但具有葡萄胎特征,遂终止妊娠。尸检和组织学检查诊断为完全性葡萄胎与正常胎儿共存,基因分析显示胎儿为二倍体,具有双亲基因组,而葡萄胎组织为父源性二倍体。该病例突出表明,即使通过卵胞浆内单精子注射实现妊娠,仍可能发生完全性葡萄胎妊娠。通过收集少数类似报道病例的数据并对这种罕见情况的发病机制进行评论,我们进行了文献综述。