双胎之一完全性葡萄胎妊娠并发侵蚀性葡萄胎1例

The occurrence of complete hydatidiform mole with co-existing fetus complicated by invasive mole:A case report

目的探讨双胎之一完全性葡萄胎妊娠的发病机制、临床特点及诊疗方法。方法回顾性分析1例双胎之一完全性葡萄胎妊娠并发侵蚀性葡萄胎病例的诊疗经过及妊娠结局,并复习相关文献。结果孕妇促排卵治疗后自然妊娠,孕期超声考虑双胎妊娠合并葡萄胎,经剖宫产获得足月新生儿。结合其临床表现、影像学检查、组织病理学特征及免疫组化,最终确诊为双胎之一完全性葡萄胎。剖宫产后随访2个月,产妇确诊为侵蚀性葡萄胎(Ⅲ:2),给予MTX单药化疗7个疗程后临床痊愈。结论双胎妊娠合并葡萄胎的处理,应综合考虑,对于双胎之一完全性葡萄胎并发侵蚀性葡萄胎更应制定个体化的诊疗方案。

Objective To explore the pathogenesis,clinical characteristics and treatment methods of complete hydatidiform mole with co-existing fetus(CHMCF).Methods A retrospective analysis was conducted on the diagnosis,treatment,and pregnancy outcome of a case involving CHMCF complicated by invasive mole,along with a review of related literature.Results The patient had a spontaneous pregnancy following ovulation induction treatment,with an ultrasound during pregnancy confirmed twin pregnancy complicated by hydatidiform mole.A full-term newborn was delivered by cesarean section.Combining clinical presentation,imaging examinations,histopathological characteristics and immunohistochemistry,the CHMCF diagnosis was confirmed.A 2-month follow-up after cesarean section revealed the diagnosis of an invasive mole(Ⅲ:2).Clinical remission was achieved after receiving 7 courses of single-agent methotrexate(MTX)chemotherapy.Conclusion Management of a twin pregnancy complicated by hydatidiform mole should be individualized,especially in cases involving CHMCF complicated by invasive mole.