Huang Xuekun, Liang Jingyao, Huang Yonghan, Huang Juanhua
Reproductive Medicine Center, Department of Obstetrics and Gynaecology, The First People's Hospital of Foshan, Foshan, 528000, Guangdong, People's Republic of China,
Arch Gynecol Obstet. 2014 May;289(5):1145-50. doi: 10.1007/s00404-013-3118-z. Epub 2013 Dec 8.
Pregnancy in Sheehan's syndrome (SS) is extremely rare. We present the first reported case of twin pregnancy with complete hydatiform mole (CHM) and a coexistent fetus (CHCF) in a patient with SS. A 29-year-old Chinese patient with SS became pregnant following one cycle of ovulation induction with human menopausal gonadotropin after secondary infertility. A normal live fetus and a low echogenic mass suspected hydatidiform mole (HM) were detected by ultrasound examinations at gestational week 8. The couple highly desired to continue the pregnancy because it is very hard to get pregnant for the patients with SS. However, the pregnancy was terminated for the size of the HM component increased rapidly at gestational week 15. Histological examinations confirmed CHCF. Genetic studies showed that the CHM genome was derived from paternal diploidy, and the normal fetus was from biparental genomes. Furthermore, a literature review on these topics is included. This case highlighted that even in a patient with SS, twin pregnancy with CHCF can still occur after ovulation induction.
希恩综合征（SS）患者怀孕极为罕见。我们报告了首例SS患者双胎妊娠合并完全性葡萄胎（CHM）及并存胎儿（CHCF）的病例。一名29岁的中国SS患者继发不孕后，经一轮人绝经期促性腺激素促排卵治疗后怀孕。孕8周超声检查发现一个正常活胎及一个低回声团块，怀疑为葡萄胎（HM）。这对夫妇强烈希望继续妊娠，因为SS患者怀孕非常困难。然而，孕15周时，由于HM部分体积迅速增大，妊娠终止。组织学检查证实为CHCF。基因研究表明，CHM基因组来源于父方二倍体，正常胎儿来源于双亲基因组。此外，还纳入了关于这些主题的文献综述。该病例突出表明，即使是SS患者，促排卵后仍可能发生CHCF双胎妊娠。
