Rai Lavanya, Shripad Hebbar, Guruvare Shyamala, Prashanth Adiga, Mundkur Anjali
Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal - 576 104, Karnataka, India.
Malays J Med Sci. 2014 Nov-Dec;21(6):61-4.
This is a case report of a twin pregnancy with one fetus and a coexistent mole diagnosed at 13 weeks. After thorough counseling, the pregnancy was continued as per the patient's desire. The pregnancy was closely monitored with serial S β hCG, ultrasound for fetal growth, size of molar sac, and theca lutein cysts, which gradually decreased in size during the second trimester of pregnancy. An emergency caesarean delivery was done at 36 weeks due to breech in early labour. A live baby weighing 1.8 kg was delivered in good condition. Her S β hCG reached normal levels at the end of three weeks, and she is now on post-molar surveillance. Though the general trend is to terminate pregnancy in twins with coexistent mole in anticipation of complications, under close surveillance, optimal outcomes can be achieved. Monitoring of S β hCG, serial ultrasound for fetal growth, size of molar component, and theca lutein cysts can help to predict good patient outcomes.
这是一例双胎妊娠病例报告,其中一个胎儿与一个共存的葡萄胎在孕13周时被诊断出来。经过充分的咨询后,根据患者的意愿继续妊娠。通过连续检测血清β-人绒毛膜促性腺激素(S β hCG)、超声监测胎儿生长情况、葡萄胎囊大小及黄素囊肿情况对妊娠进行密切监测,在妊娠中期这些指标逐渐减小。由于早产时胎位为臀位,在孕36周时进行了急诊剖宫产。一名体重1.8千克的活产婴儿顺利娩出。产后三周时她的S β hCG达到正常水平,目前她正在接受葡萄胎后监测。尽管一般趋势是预期会出现并发症而终止双胎妊娠合并共存葡萄胎的妊娠,但在密切监测下,可以实现最佳结局。监测S β hCG、连续超声监测胎儿生长、葡萄胎成分大小及黄素囊肿情况有助于预测患者的良好结局。