Soriano-Estrella Agnes L, Velasco-Redondo Victoria May H
Division of Trophoblastic Diseases, Department of Obstetrics and Gynecology, Philippine General Hospital, University of the Philippines Manila.
Acta Med Philipp. 2024 Jun 28;58(11):81-89. doi: 10.47895/amp.v58i11.8080. eCollection 2024.
Hydatidiform mole coexistent with a live fetus (CMCF) is a rare entity occurring in 1:20,000 to 1:100,000 pregnancies. Three mechanisms of this type are possible: (1) a singleton pregnancy consisting of partial mole with a triploid fetus, (2) a twin gestation consisting of an androgenic complete hydatidiform mole with a biparental diploid fetus, and (3) a twin gestation consisting of a biparental diploid fetus with a normal placenta and a partial hydatidiform mole (PHM) with a triploid fetus. The abnormal triploid fetus in a partial mole tends to die in the first trimester while the fetus coexisting with a complete or partial mole in the dizygotic twin pregnancy has a chance to survive. Early detection and diagnosis of a molar gestation with a viable fetus is needed to allow medical interventions, if available. Three cases of complete mole with a twin fetus (CMTF) that were diagnosed in the prenatal period by ultrasonography will be presented. This report will also discuss the indications for continuing the pregnancy, and review the literature on the recommended prenatal care, intrapartum management, and postpartum surveillance. This report aims to encourage others to document cases of CMTF in order to arrive at a consensus regarding its optimal management.
葡萄胎合并活胎（CMCF）是一种罕见情况，在每20000至100000次妊娠中发生1例。这种情况有三种可能机制：（1）单胎妊娠，由部分性葡萄胎和三倍体胎儿组成；（2）双胎妊娠，由雄激素性完全性葡萄胎和双亲二倍体胎儿组成；（3）双胎妊娠，由双亲二倍体胎儿和正常胎盘以及部分性葡萄胎（PHM）和三倍体胎儿组成。部分性葡萄胎中的异常三倍体胎儿往往在孕早期死亡，而在双卵双胎妊娠中与完全性或部分性葡萄胎共存的胎儿有存活机会。需要早期检测和诊断葡萄胎合并存活胎儿，以便在有可用医疗干预措施时进行干预。将介绍3例产前通过超声诊断的完全性葡萄胎合并双胎胎儿（CMTF）病例。本报告还将讨论继续妊娠的指征，并回顾关于推荐的产前护理、产时管理和产后监测的文献。本报告旨在鼓励其他人记录CMTF病例，以便就其最佳管理达成共识。
