双胎妊娠并部分性葡萄胎及双胎输血综合征一例报告

Twin Pregnancy Combined with Partial Hydatidiform Mole and Twin to Twin Transfusion Syndrome: a Case Report

目的探讨双胎妊娠并部分性葡萄胎及双胎输血综合征的临床特点。方法回顾性分析我院收治的双胎妊娠并部分性葡萄胎及双胎输血综合征1例的临床资料。结果本例因孕21+5周、双胎,发现高血压1周入院。诊断为妊娠期高血压疾病、重度子痫前期,予降压、解痉、输注白蛋白等对症治疗,血压控制欠佳,水肿症状加重,双胎胎心正常,其中一胎胎动减少,遂行利凡诺羊膜腔注射引产术,后因子宫收缩欠佳,急行B超引导下清宫术。术后检查胎盘并行组织病理学检查,确诊为双胎妊娠并部分性葡萄胎及双胎输血综合征,予对症治疗后好转出院。随访4月余,患者恢复良好,复查血人绒毛膜促性腺激素及X线胸片未见异常。结论临床收治血压升高的双胎妊娠者,要警惕部分性葡萄胎及双胎输血综合征的可能,及时行医技检查,尽早确诊并治疗,以改善预后。

Objective To investigate clinical characteristics of twin pregnancy combined with partial hydatidiform mole and twin to twin transfusion syndrome. Methods Clinical data of 1 patient with twin pregnancy combined with partial hydatidiform mole and twin to twin transfusion syndrome was retrospectively analyzed. Results The pregnant woman was ad-mitted for hypertension for 1 week during 21 ＋5 weeks twin pregnancying, and she was diagnosed as having hypertensive disor-ders in gestation period and severe pre-eclampsia, and then symptomatic treatments such as decompression, antispasmodic and albumin infusion were given. Blood pressure was badly controlled, and edema symptoms aggravated, and fetal hearts of twins were normal, and a foetus was found decreased fetal movement, and then Rivanol amniotic cavity injection induced labor was given, but emergency B-guided complete curettage was performed due to poor uterine contraction. The twin pregnancy com-bined with partial hydatidiform mole and twin to twin transfusion syndrome was confirmed by postoperative placenta and his-topathologic examinations, and the patient＇s condition was improved and discharged after symptomatic treatments. With follow-up for more than 4 months, the patient recovered well, and no abnormal condition was found by rechecking human chorionic gonadotropin and chest X-ray. Conclusion Pregnant women with twin pregnancy and increasing blood pressure should be a-lert to occurrence of partial hydatidiform mole and twin to twin transfusion syndrome, and timely medical examination should be given in time to confirm the diagnosis in order to treatment as early as possible to improve the prognosis.