双绒毛膜妊娠合并三倍体胎儿时选择性终止妊娠用于子痫前期治疗：一例报告
Selective fetal termination for preeclampsia treatment in a dichorionic gestation with a triploid fetus: A case report.
作者信息
Gulersen Moti, Vohra Nidhi, Bonanno Clarissa
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, North Shore University Hospital - Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States of America.
出版信息
Case Rep Womens Health. 2022 Apr 25;34:e00415. doi: 10.1016/j.crwh.2022.e00415. eCollection 2022 Apr.
BACKGROUND
Triploidy is commonly associated with the development of early-onset preeclampsia. While previable preeclampsia is often a contraindication to prolonging pregnancy, there may be rare circumstances in which an alternative approach may be offered.
CASE
A nulliparous patient with a dichorionic twin gestation, recently diagnosed triploidy in one twin, and history of chronic hypertension presented at 18 weeks of gestation with signs and symptoms suggestive of preeclampsia. After symptomatic therapy and laboratory evaluations, selective fetal termination of the affected twin was elected and performed without complications. The patient subsequently delivered a healthy newborn at 37 weeks of gestation.
CONCLUSION
Selective fetal termination may be considered a management option for previable preeclampsia in a dichorionic gestation with triploid fetus and was associated with a favorable outcome in this case.
背景
三倍体常与早发型子痫前期的发生有关。虽然未达到可存活孕周的子痫前期通常是延长妊娠的禁忌证，但在某些罕见情况下，可能会有其他处理方法。
病例
一名初产妇，双绒毛膜双胎妊娠，近期诊断其中一个胎儿为三倍体，有慢性高血压病史，孕18周时出现提示子痫前期的症状和体征。经过对症治疗和实验室评估后，选择对受影响的胎儿进行选择性终止妊娠，手术顺利，无并发症。该患者随后在孕37周时分娩出一名健康新生儿。
结论
对于双绒毛膜妊娠合并三倍体胎儿且未达到可存活孕周的子痫前期，选择性胎儿终止妊娠可被视为一种处理选择，本病例显示该方法取得了良好结局。
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