双胎之一葡萄胎产前诊断与处理

Prenatal diagnosis and management of twin pregnancies complicated by a coexisting molar pregnancy

目的探讨双胎之一葡萄胎的产前诊断方法与处理策略。方法回顾性分析2010年3月至2018年6月在广东省妇幼保健院诊断的3例双胎之一葡萄胎的临床特点与妊娠结局。结果 3例病例均为双胎之一完全性葡萄胎,其中1例为辅助生殖受孕。1例为双子宫受孕。所有病例首次超声检查均未发现葡萄胎,平均产前诊断孕周为14.0周(13～17周)。所有患者均选择终止妊娠,平均终止妊娠时间为16.3周(13～20周)。3例病例均合并并发症。所有病例均无胎儿存活。结论双胎之一葡萄胎早期诊断较为困难,应行详细的超声检查,临床诊治应结合患者及胎儿情况个体化处理。

Objective To investigate the prenatal diagnosis and management of twin pregnancies complicated by a coexisting molar pregnancy.Method Retrospective analysis of three cases of twins pregnancies complicated by a coexisting molar pregnancy in Guangdong Women and Children Hospital.Results Three cases were all twin pregnancies complicated by a complete mole and coexisting fetus.Overall,one case was conceived with assisted reproductive technology and one case was conceived separately in uterus didelphys.All the cases did not detect molar pregnancy for the first ultrasound examination and the mean gestation age at diagnosis was14.0weeks(13~17weeks).All the women opted to terminated the pregnancy and the mean terminated gestation was16.3weeks(13~20weeks).Three cases(100%)were complicated with complications.And there were no fetus survival.Conclusions Multiple pregnancies complicated by a coexisting molar pregnancy are rarely occurred.The prenatal diagnosis is difficult.Management is complicated and women should be counselled about the maternal and fetal complications.