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双胎妊娠合并完全性葡萄胎与健康胎儿:病例报告及文献复习

Twin pregnancy combining complete hydatidiform mole and healthy fetus: Case report and review of the literature.

作者信息

Khalloufi Chadia, Joudar Imane, El Abbassi Imane, Jalal Mohammed, Lamrissi Amine, Bouhya Said

机构信息

Maternity, University Hospital Abderrahim Harouchi, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Ain chock BP 5366, 20000 Casablanca, Morocco.

Maternity, University Hospital Abderrahim Harouchi, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Ain chock BP 5366, 20000 Casablanca, Morocco.

出版信息

Int J Surg Case Rep. 2023 Apr;105:107959. doi: 10.1016/j.ijscr.2023.107959. Epub 2023 Mar 4.

Abstract

INTRODUCTION AND IMPORTANCE

Twin pregnancy combining a complete mole and a normal fetal pregnancy with its own healthy trophoblast is a rare entity. A partial molar pregnancy almost always ends in miscarriage due to a triploid fetus.

CASE PRESENTATION

We report the case of a 43-year-old female patient admitted for bleeding during the 20th week of pregnancy. Pelvic ultrasound showed the combination of a complete hydatidiform mole and a normal fetal pregnancy. The decision to medically terminate the pregnancy was taken after consultation with the family. Examination of the placenta and histological study confirmed the diagnosis of complete hydatidiform mole associated with a normal fetus. The evolution was uneventful.

CLINICAL DISCUSSION

Twin pregnancy combining a complete mole and a normal fetal pregnancy with its own healthy trophoblast is a rare entity that should not be misdiagnosed. There is still no consensus in terms of therapeutic attitude, the dilemma remains and the decision should always include the couple after a thorough explanation of all the risks.

CONCLUSION

Our case reaffirms that to successfully manage this rare yet life-threatening condition, heterotopic pregnancy should be included in the differential diagnosis for any gravid women presenting with persistent abdominal pain, abnormal bleeding and/or extrauterine mass.

摘要

引言与重要性

双胎妊娠合并完全性葡萄胎及具有自身健康滋养层的正常胎儿妊娠是一种罕见情况。部分性葡萄胎几乎总是因三倍体胎儿而以流产告终。

病例报告

我们报告一例43岁女性患者,在妊娠第20周时因出血入院。盆腔超声显示完全性葡萄胎与正常胎儿妊娠并存。在与家属协商后决定进行药物性终止妊娠。对胎盘进行检查及组织学研究证实诊断为完全性葡萄胎合并正常胎儿。病情进展平稳。

临床讨论

双胎妊娠合并完全性葡萄胎及具有自身健康滋养层的正常胎儿妊娠是一种罕见情况,不应误诊。在治疗态度方面仍未达成共识,困境依然存在,在充分解释所有风险后,决策应始终包括夫妇双方。

结论

我们的病例再次证实,为成功处理这种罕见但危及生命的情况,对于任何出现持续性腹痛、异常出血和/或宫外肿块的孕妇,应将异位妊娠纳入鉴别诊断。

相似文献

6
[Twin pregnancy with complete hydatidiform mole].
Arkh Patol. 2017;79(5):43-48. doi: 10.17116/patol201779543-48.
8
Complete mole coexistent with a twin fetus.完全性葡萄胎合并双胎妊娠。
Arch Gynecol Obstet. 2010 Jan;281(1):119-22. doi: 10.1007/s00404-009-1076-2. Epub 2009 Apr 16.

本文引用的文献

9
Hydatiform mole with coexisting live fetus in dichorionic twin gestation.双绒毛膜双胎妊娠中并存活胎的葡萄胎
Eur J Obstet Gynecol Reprod Biol. 2001 Feb;94(2):301-3. doi: 10.1016/s0301-2115(00)00338-9.

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