Sindiani Amer, Obeidat Basil, Alshdaifat Eman
Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, Irbid, Jordan.
Am J Case Rep. 2020 Apr 1;21:e923395. doi: 10.12659/AJCR.923395.
BACKGROUND A complete mole with a living fetus in a form of twin pregnancy that is a rare obstetric event. The development of metastatic gestational trophoblastic disease is the most important and serious complication. It is debatable whether to terminate the pregnancy or to continue. Another point is the validity of the conservative treatment of this type of neoplasm, especially in developing countries. CASE REPORT In this study, we report the first case of a twin pregnancy with complete mole and a living fetus in Jordan, which is a developing country. A 33-year-old woman presented with vaginal bleeding which was revealed to be due to a complete mole in the form of a twin pregnancy. A hystrostomy was performed with subsequent drop of ß-hCG level. However, the ß-hCG started to rise and the CT scan revealed multiple metastatic sites. Accordingly, she received 3 cycles of methotrexate, with a subsequent reduction in ß-hCG level. CONCLUSIONS This is the first case report of a complete mole in twin pregnancy in Jordan. To overcome the development of metastasis, close follow-up and immediate treatment are crucial when the conservative approach is being considered. This report highlights the importance of considering the diagnosis of complete mole for women with twin and vaginal bleeding.
背景 双胎妊娠中存在活胎的完全性葡萄胎是一种罕见的产科事件。转移性妊娠滋养细胞疾病的发生是最重要且严重的并发症。对于是否终止妊娠存在争议。另一个问题是这种类型肿瘤保守治疗的有效性，尤其是在发展中国家。病例报告 在本研究中，我们报告了约旦（一个发展中国家）首例双胎妊娠合并完全性葡萄胎及活胎的病例。一名33岁女性因阴道出血就诊，检查发现是双胎妊娠形式的完全性葡萄胎所致。进行了子宫造口术，随后β - hCG水平下降。然而，β - hCG又开始上升，CT扫描显示有多个转移部位。因此，她接受了3个周期的甲氨蝶呤治疗，随后β - hCG水平降低。结论 这是约旦首例双胎妊娠合并完全性葡萄胎的病例报告。为避免转移的发生，在考虑采用保守方法时，密切随访和及时治疗至关重要。本报告强调了对于双胎妊娠且有阴道出血的女性考虑完全性葡萄胎诊断的重要性。
