Ibargüengoitia F, Lira Plascencia J, Argueta Zúñiga M, Cabral Castañeda F
Instituto Nacional de Perinatología, Méx., D.F.
Ginecol Obstet Mex. 1995 Jul;63:275-8.
The rate of hydatidiform mole in our country oscillates from 1:144 to 1:552 pregnancies. We report the second case of hydatidiform mole coexisting with a spontaneous multiple pregnancy (three fetuses and one hydatidiform mole). The patient was a 34 year old woman. She had not received hormonal therapy for anovulation. At 13th weeks of gestation she presented vaginal spotting and hyperemesis. An ultrasonographic examination revealed three living fetuses and the multiple cystic echo typical of an hydatidiform mole. At 14 weeks of pregnancy she was diagnosed to have clinical symptoms of severe preeclampsia. We did not have an adequate response to the antihypertensive drugs and the patient underwent therapeutic termination of the pregnancy. The thyroid hormones were in normal levels. The serum beta-hCG was up to 500,000 mU/ml. Two fetuses were female weighing 55 g. each one. One fetus was male weighing 50 g. All of them had a normal karyotype. The patient development a gestational trophoblastic disease. These have been only three reports of complete hydatidiform mole in triplet pregnancy with two fetuses. These cases were pregnancies occurring after ovulation inducing therapy. We analyzed the clinical aspects and treatment of hydatidiform mole coexisting with multiple pregnancy.
我国葡萄胎的发生率在每144至552次妊娠中有1例波动。我们报告了第二例葡萄胎与自然多胎妊娠（三胞胎和一个葡萄胎）共存的病例。患者为一名34岁女性。她未曾接受过促排卵的激素治疗。妊娠13周时，她出现阴道点滴出血和剧吐。超声检查显示有三个存活胎儿以及葡萄胎典型的多个囊性回声。妊娠14周时，她被诊断出患有重度子痫前期的临床症状。我们对抗高血压药物反应不佳，患者接受了治疗性终止妊娠。甲状腺激素水平正常。血清β - hCG高达500,000 mU/ml。两个胎儿为女性，各重55克。一个胎儿为男性，重50克。所有胎儿核型均正常。患者发展为妊娠滋养细胞疾病。仅有三篇关于三胎妊娠中两个胎儿合并完全性葡萄胎的报道。这些病例均为促排卵治疗后发生的妊娠。我们分析了葡萄胎与多胎妊娠共存的临床情况及治疗。
