Complete Hydatidiform Mole at Menopause: A Case Report from Panzi Hospital, Bukavu, Democratic Republic of Congo

Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.

Termination of a partial hydatidiform mole and coexisting fetus: A case report

BACKGROUND We describe the treatment strategy for a patient who was found to have a partial hydatidiform mole and coexisting fetus(PHMCF)during the second trimester.The patient was a 38-year-old Chinese woman who had become pregnant following in vitro fertilization and embryo transplantation.We wanted to determine the safest therapeutic strategy to terminate the PHMCF during the second trimester.CASE SUMMARY In this case,we present a patient who was found to have a PHMCF complicated with serious continuous vaginal bleeding and pre-eclampsia during the second trimester.After careful evaluation,the pregnancy was considered to be unsustainable and was terminated via caesarean section(CS).An infant with weak vital signs and a partially cystic placenta measuring 110 mm×95 mm×35 mm were delivered by CS.The patient was discharged after 4 d.The serum levels ofβ-human chorionic gonadotropin decreased to within a normal range 5 wk after the operation,and no evidence of persistent trophoblastic disease or lung metastases was noticed at the 6-mo follow-up.CONCLUSION CS termination of PHMCF during the second trimester may be a relatively safe therapeutic strategy.

Hydatidiform mole in a scar on the uterus:A case report

BACKGROUND Cesarean scar molar pregnancy is extremely rare,but the incidence has been rising due to the continuous increase in the rate of cesarean section.The presence of a hydatidiform mole in the scar left on the uterus by the procedure may lead to severe complications.We performed a literature review and found only seven reported cases of cesarean scar molar pregnancy.Accurate diagnosis and appropriate treatment are extremely important for the patients’prognosis.CASE SUMMARY A 35-year-old woman,gravida 4,para 1,complained of vaginal bleeding lasting more than 1 mo and amenorrhea lasting more than 2 mo.The patient’s serum human chorionic gonadotropin was 4287800 IU/L.Ultrasound showed a 11.5 cm×7.5 cm mass at the anterior lower wall of the uterus.The patient underwent suction evacuation,and partial grape-like tissue mixed with blood clots was removed.Uterine arterial embolization was performed to control intraoperative and postoperative bleeding.Histological examination confirmed the presence of a hydatidiform mole in uterine scar.After surgery,there was still a mass with heterogeneous intensity near the isthmus of the uterus on magnetic resonance imaging.The patient then underwent chemotherapy.During the 6-mo follow-up period,the mass disappeared and the serum human chorionic gonadotropin level gradually decreased to normal level.CONCLUSION We report a case of cesarean scar molar pregnancy successfully cured by comprehensive treatment.We found that cesarean scar molar pregnancy was subject to intraoperative bleeding,and uterine arterial embolization before surgery may be helpful.

Genetically identified complete hydatidiform mole coexisting with a normal fetus following IVF-ET

A complete hydatidiform mole coexisting with a fetus following in vitro fertilization and embryo transfer (IVF-ET) is a rare event. The diagnosis is often not easy because of the morphological similarity to a partial mole, but important to the treatment. We present a recent case in which STR polymorphism analysis clearly revealed a different genetic origin for the fetal and molar parts. STR polymorphisms on 15 variable number tandem repeat loci and a gender-determination locus, which were detected by polymerase chain reaction, indicating that the cord/placenta and molar tissue were parental and androgenous, respectively. During follow-up, the patient developed persistent gestational trophoblastic tumor (GTT) which was successfully treated with chemotherapy. In this case, STR polymorphism analysis exactly diagnosed a twin pregnancy consisting of a complete hydatidiform mole and a fetus.

Preliminary Study on c-Ha-ras Oncogene Mutations in Hydatidiform Mole Tissues

ve To study the presence of c-Ha-ras oncogene mutations in hydatidiform mole (HM) tissues and to further explore its relationship with mole's malignancy

Low and Maternal-specific Expression of p57^(KIP2) in Hydatidiform Mole and Its Clinical Implication

Summary: In situ hybridization was applied to locate and detect the expression of p57 KIP2 in hydatidiform mole (5 cases of partial hydatidiform mole and 18 cases of complete hydatidiform mole) and normal villi (23 cases). The positive signals of p57 KIP2 expression were analyzed by HPIAS-1000 Image-Analysis System. p57 KIP2 was highly expressed in normal villi but showed distinct low expression in hydatidiform mole (P<0.01). Furthermore, the locus of low expression of p57 KIP2 accorded with the place where lesion of trophoblast occurred. Detection of p57 KIP2 made it possible to study the genetics of hydatidiform mole at the transcriptional level. Low expression of p57 KIP2 could be a molecular marker in hydatidiform mole and a target for therapy.

Single Nucleotide Polymorphism-Based Chromosomal Microarray Evaluation of Hydatidiform Moles: A US National Reference Laboratory Experience

Objectives: This retrospective study evaluated 1) benefits of single nucleotide polymorphism (SNP)-based chromosomal microarrays (CMAs) in the diagnosis of complete hydatidiform mole (CHM) and partial HM (PHM) in products of conception (POC) and amniotic fluid (AF) specimens, and 2) frequency of whole-genome uniparental disomy (wgUPD) and triploidy in POC and AF specimens received at a US national reference laboratory. Methods: We reviewed consecutive 2138 POC and 3230 AF specimens and identified the cases with wgUPD and triploidy which are associated with molar pregnancy. Results: Of 2138 consecutive POC specimens tested, SNP-based CMA detected wgUPD in 10 (0.47%) and triploidy in 84 (3.93%). Of the 10 wgUPD cases, 9 (90%) were confirmed as CHM. Of 3230 consecutive AF specimens, the array detected wgUPD in 1 case (0.03%) and triploidy in 11 (0.34%). Conclusions: SNP-based microarray allows detection of wgUPD in POC and AF specimens at a US national reference laboratory. Correctly diagnosing HM and differentiating CHM from PHM are important for clinical management. The effective SNP-based CMA detection of wgUPD in CHM may enable physicians to monitor patients at risk for gestational trophoblastic disease and neoplasm. Conventional chromosome analysis of POC has a high failure rate, cannot be performed on formalin-fixed paraffin embedded samples, and cannot detect wgUPD. Further multi-institutional collaborative assessmen on accuracy, cost-effectiveness, and adequate access to SNP-based CMA, may lead this testing platform to be considered as the first-tier analysis tool for POC specimens, including those showing PHM or CHM.

The changes of clinical features of hydatidiform mole:analysis of 113 cases

Objective:To investigate the changes of the clinical features of hydatidiform mole.Methods:One hundred and thirteen cases of hydatidiform mole treated in Peking Union Medical College Hospital during 1989-2006 were reviewed retrospectively and a comparison was made to historic data(1948-1975)using χ2 test.Results:The median age was 28 years(ranges from 20 to 55 years).The median gestational age was 90.2 days.Vaginal bleeding remaines the most common presenting symptom,ocurring in 94 of 113 cases(83.2%).Fifty-two of 113 cases(46%)presented with excessive uterine size.Pregnancy induced hypertension syndome(PIH),hyperemsis,hemoptysis and theca lutein cysts occurred in 4 of 113(3.5%),12 of 113(10.6%),4 of 113(3.5%)and 19 of 113 cases(16.8%)respectively.Incidence of postmolar trophoblastic neoplasia was 21%(24 of 113).Campared to historic data,the incidence of vaginal bleeding and PIH were statistically lower(P<0.005).The incidence of postmolar gastational trophoblastic neoplasia(GTN)was increased moderately without statistical significance compared to historic data.Conclusions:Because of the wide use of ultrasonography and serum hCG test,the current patients with hydatidiform mole have been diagnosed earlier in gestation and the clinical features have changed.Patterns of medical practice should be changed accordingly.

Detection of Homozygous Deletions and Mutations in the CDKN2A Gene in Hydatidiform Moles

OBJECTIVE To investigate homozygous deletions and mutations in the CDKN2A gene(p16 INK4a and p14 ARF gene)in hydatidiform moles. METHODS A total of 38 hydatidiform mole samples and 30 villi samples were examined for homozygous deletions in the CDKN2A gene by PCR and for mutations by DHPLC. RESULTS i)Among 38 hydatidiform mole samples, homozygous deletions in the p16 INK4a exon 1 were identified in 5 cases(13.2%),while no homozygous deletions were found in the p16I NK4aexon 1 of 30 early-pregnancy samples.The rates of those deletions in hydatidiform compared to early-pregnancy villi samples was statistically significant(P=0.036).ii)No homozygous deletions in the p14 ARF exon 1 or p16 INK4a exon 2 were found in any of the hydatidiform moles or early-preganancy samples.iii) In all hydatidiform moles and early-pregnancy villi samples,no mutations were detected by DHPLC. CONCLUSION We suggest there may be a close correlation between homozygous deletions in the CDKN2A gene and occurrence of hydatidiform moles variation in the CDKN2A gene is mainly caused by homozygous deletions,while mutations may be not a major cause.

Study on neoplasia of hydatidiform mole by detecting telomerase reverse transcriptase mRNA expression in peripheral blood mononuclear cells

Objective: By setting up a real-time fluorescent quantitative RT-PCR assay to detect human telomerase reverse transcriptase (hTERT) mRNA in hydatidiform mole in peripheral blood mononuclear cells, to analyze the correlation between the expression level of hTERT mRNA and the prognosis of hydatidiform mole, and to evaluate the clinic value of quantitative determination of hTERT mRNA in the diagnosis of hydatidiform mole. Methods: A real-time fluorescent quantitative RT-PCR (FQ RT-PCR) assay based on TaqMan fluorescence methodology and the Light-Cycler system was used to quantify the full range of hTERT mRNA copy numbers in 30 samples of hydatidiform mole and the neoplasia of hydatidiform mole. The normalized hTERT (NhTERT) was standardized by quantifying the number of GAPDH transcripts as internal control and expressed as 100× (hTERT/GAPDH) ratio. Based on the prognosis of the hydatidiform mole, the patients were divided into two groups: the experimental group and the control group, to compare the telomerase reverse transcriptase mRNA expression in peripheral blood mononuclear cells. Results: hTERT mRNA was both expressed in the peripheral blood mononuclear cells and pathological tissues in the mole experimental group and the control group. In the mole experimental group, the values were 6.31±0.32 and 6.24±0.44, respectively, and there was no significant difference between them (P>0.05). But in the control group the values were 1.21±0.65 and 1.40±0.61, respectively, and there was no significant difference between them (P>0.05). The values in experimental group was significantly higher than those in the control group (P<0.01). Conclusion: Quantitative determination of hTERT mRNA by FQ RT-PCR is a rapid and sensitive method. hTERT in peripheral blood mononuclear cells may have potential use as a biomarker for the early detection of the prognosis of the hydatidiform mole.

双胎之一完全性葡萄胎妊娠并发侵蚀性葡萄胎1例

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。

中期妊娠合并完全性葡萄胎继发远处转移1例并文献复习

目的探讨中期妊娠合并完全性葡萄胎(CHMCF)继发远处转移病例的临床特征和诊疗方法。方法回顾性分析2021年7月湖北省妇幼保健院收治的1例CHMCF患者的诊治经过及随访情况,结合文献复习探讨其诊治策略。结果本例患者因先兆流产收入院保胎治疗,彩超提示宫腔内除正常胎儿胎盘组织外另有一蜂窝样无回声区;行药物引产术,术后确诊CHMCF;随访期间血人绒毛膜促性腺激素(β-HCG)下降不佳,肺部出现微小转移灶,予以一周期甲氨蝶呤化疗后降至阴性,随访半年余未复发。结论CHMCF是一种高风险妊娠,超声结合血β-HCG的动态监测对CHMCF的早期识别具有重要意义,同时完善的遗传学筛查对其临床处置和预后具有指导意义。在临床处理上,应结合产前母体并发症有无、血β-HCG增长趋势及患者对继续妊娠风险的承受力制定个体化诊疗方案。此外,终止妊娠后的密切随访对于优化母胎结局亦至关重要。

输卵管妊娠葡萄胎合并腹腔内出血一例

输卵管妊娠葡萄胎在临床上极为罕见,术前诊断大多存在困难,确诊主要依靠术后组织病理学诊断。报告1例38岁女性因右侧输卵管妊娠破裂致腹腔内出血急诊行腹腔镜右侧输卵管切除术,术后病理提示完全性葡萄胎的病例。该患者术后恢复良好,随访期间血清人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)下降满意,无阴道出血、咳嗽和咳血等相关病灶转移症状。输卵管妊娠葡萄胎多表现为急腹症,因此对于急腹症患者临床上应警惕葡萄胎的可能性,其治疗多以手术为主,必要时行化疗,术后需严密随访,注意病变侵蚀及恶变可能。

CNV结合STR分型技术检测孕早期流产组织潜在葡萄胎效果及风险因素分析

目的:评估基因组拷贝数变异测序(CNV-seq)结合短串联重复序列(STR)多态性分析技术在检测孕早期(≤9周)流产物组织中潜在葡萄胎病例的应用效果.方法:收集2021年1月-2022年12月行孕早期流产组织CNV-seq结合STR多态性检测病例114例,其中部分新鲜绒毛组织进行CNV-seq结合STR多态性检测,部分组织行病理学检测.比较两种检测方法结果,并分析潜在葡萄胎病例的临床特征和影响因素.结果:CNV-seq结合STR多态性检测共检出染色体异常病例28例,阳性率为24.6%,其中单亲二倍体(UPD)8例,占阳性病例28.6%;病理学检出葡萄胎病例12例,阳性率为10.5%,其中完全性葡萄胎(CHM)10例,占阳性病例的83.3%.两种检测方法的结果一致率为89.5%,Kappa值为0.75,两种方法具较好一致性.潜在葡萄胎病例与非葡萄胎病例在年龄、孕次、流产次、β-hCG水平、超声表现等方面有差异,其中年龄、β-hCG水平和超声表现是潜在葡萄胎危险因素(均P<0.05).结论:CNV-seq结合STR多态性分析技术能有效检测孕早期流产物组织中潜在葡萄胎病例,有助于指导临床治疗和避免再次流产.

超声诊断葡萄胎合并妊娠49例临床分析

目的:探讨葡萄胎合并妊娠的超声诊断价值及其预后。方法:回顾性分析2014年1月至2023年4月于四川大学华西第二医院超声诊断疑似葡萄胎合并妊娠的49例孕妇的临床资料,并根据病理检查结果分为葡萄胎组(20例)和良性病变组(25例),分析两组的超声检查和临床特征,并对不同医师超声图像的判读采用一致性检验。结果:①49例患者中31例孕妇选择终止妊娠,14例孕妇选择继续妊娠,4例失访。有明确病理诊断的45例患者,其中完全性葡萄胎4例,部分性葡萄胎16例;良性病变共25例,包括胎盘间叶发育不良5例、胎盘绒毛发育异常4例、胎盘粘连2例、胎盘梗死1例等。超声诊断葡萄胎合并妊娠的准确率44.4%(20/45)。②与良性病变组比较,葡萄胎组患者中占位的体积明显较大、占位中无回声的数量(一个切面>15个)明显较高、单个无回声的大小差异(≥80%)明显较低,差异均有统计学意义(P<0.05)。③2位超声医师对葡萄胎合并妊娠的超声图像进行判读,所有超声判读结果Kappa一致性系数均在0.75以上。结论:占位体积越大、占位中的无回声数量越多(一个切面>15个)、占位中无回声分布大小越一致越倾向诊断葡萄胎合并妊娠。胎盘间叶发育不良等良性疾病的超声表现易与葡萄胎混淆,应谨慎。虽然超声诊断的准确率不高,但及时发现异常便于临床管理。

经阴道彩超联合血清β-HCG早期诊断不典型葡萄胎的临床价值探讨

目的:探讨分析经阴道彩超联合人绒毛膜促性腺激素(血清β-HCG)早期诊断不典型葡萄胎的临床价值。方法:选取2020年5月-2023年5月我院收治的行阴道超声检查疑似不典型葡萄胎患者60例,所有患者行经阴道彩超检查和血清β-HCG检测,比较患者的血清β-HCG浓度,采用Kappa一致性分析两种方法诊断不典型葡萄胎的临床价值。结果:经过病理学检查,60例患者中32例不典型葡萄胎,28例阴性。不典型葡萄胎组血清β-HCG浓度为(156866.92±6825.32)mIU/ml高于阴性组的血清β-HCG浓度(77138.22±3257.68)mIU/ml,差异有统计学意义(P<0.05);经阴道超声检查诊断不典型葡萄胎32例,其中真阳性21例,误诊11例,漏诊8例;血清β-HCG检测诊断不典型葡萄胎33例,其中真阳性23例,误诊10例,漏诊9例;经阴道超声检查联合血清β-HCG检测诊断不典型葡萄胎41例,其中真阳性30例,误诊11例,漏诊2例;Kappa一致性分析结果显示:经阴道超声检查,灵敏度为68.75%、特异度为64.29%、准确率为66.67%、Kappa值为0.330;血清β-HCG检测,灵敏度为71.88%、特异度为64.29%、准确率为68.33%、Kappa值为0.362;经阴道超声检查联合血清β-HCG检测,灵敏度为93.75%、特异度为60.71%、准确率为78.33%、Kappa值为0.556;联合检查的灵敏度高于经阴道超声检查和血清β-HCG检测,差异有统计学意义(P<0.05)。结论:使用经阴道彩超联合血清β-HCG,可以提高诊断不典型葡萄胎准确率,可以用于临床诊断。

The value of PAPP-A in the diagnosis and prognosis of GTD

Objective： To investigate the value of PAPP-A （pregnancy assouated plasma protein-A） in the diagnosis and prognosis of gestational trophoblastic disease （GTD）. Methods： The serum 13-HCG （β-human chorionic gonadotropin） and PAPP-A levels of 25 normal pregnant women, 28 patients with complete hydatidiform mole and 38 patients with invasive mole were measured by enzyme linked immunosorbent assay （ELISA） during the periods of diagnosis, treatment and follow-up. Results： Compared with control group, patients with complete mole and invasive mole had higher levels of β-HCG （P 〈 0.01）. But there was no significant difference between the complete and invasive mole group （P 〉 0.05）. The PAPP-A level of complete mole group was significantly higher than that of control group （P 〈 0.01）. The PAPP-A level of invasive mole group was significantly higher than that of complete mole group and control group（P 〈 0.05）. In complete mole group, serum β-HCG and PAPP-A levels of the patients with malignant sequelae were significantly higher than those with benign sequelae （P 〈 0.05）. The β-HCG level had no relationship with the clinical stage of invasive mole. However, the PAPP-A level increased with clinical advancement of invasive mole. The levels of β-HCG and PAPP-A gradually decreased after evacuation in patients with complete moles, but maintained positive or even increased in patients with subsequent malignancy diagnosis of hydatidiform mole and invasive mole, but Conclusion： The PAPP-A level can give us some help not only in early also in the prognosis of malignant sequelae.

Histopathologic Profile of Miscarriages during First Trimester of Pregnancy in Teaching Hospital of Grand Yoff in Dakar (Senegal)

Background: Mainly for economic reasons, histopathologic analysis is not a systematic practice in medical structures in Senegal, and the utility of this exam is being questioned by many authors. The purpose of this paper is to report the results of this exam, in our medical practice and try to determine if this exam should be systematic of kept only for individualized cases. Material and Methods: It was a retrospective study from January 2010 to December 2018, carried out in the Laboratory of Pathology of the Teaching Hospital of Grand Yoff in Dakar. The data were collected from the register of pathologic examinations of the laboratory. Results: We registered 543 results of histopathologic examination of products of conception from the first trimester abortion. The women mean age was 22.4 years ± 6.2 with extremes of 17 and 46 years. The routine histopathologic assessment of products of first- trimester miscarriages highlighted in our study three pathologies: hydatidiform mole (24.7%), infection (4.6%) and ectopic pregnancy (0.09%). Only 11.7% of cases of Hydatidiform mole (HM) were suspected before the histopathologic assessment. In our sample, molar pregnancy seems to be higher in anembryonic conception with a prevalence of 45%. The prevalence of Complete Hydatidiform Mole (CHM) was higher than the one of Partial Hydatidiform Mole (PHM) (14.8% vs. 9.9% of miscarriages). Indeed, both require follow up to prevent or manage at time the occurrence of choriocarcinoma. Conclusion: The results of the histologic analysis after abortion in the first trimester of pregnancy show that this exam should be practiced systematically in routine in our context because of high prevalence of hydatidiform mole.

双胎之一完全性葡萄胎六例临床分析

目的:探讨双胎之一完全性葡萄胎(complete hydatidiform mole with co-existing fetus,CHMCF)的临床特征、诊断及处理。方法:回顾性分析2019年1月—2021年12月郑州大学第一附属医院收治的6例CHMCF患者的临床资料,采用描述性方法对数据进行分析。结果:6例CHMCF孕妇的年龄为(27.8±5.3)岁,中位妊娠次数3(1~6)次,中位发现孕周为14+1周(8+5~24周)。4例妊娠期反复阴道出血,2例出现妊娠剧吐,1例出现甲状腺功能亢进。6例患者中位血清人绒毛膜促性腺激素β亚单位(human chorionic gonadotrophin-β,β-hCG)最高值为389527(225354~1323961)U/L;5例超声提示妊娠合并葡萄胎,1例超声提示部分性葡萄胎。1例行产前诊断未发现异常,其余病例拒绝产前诊断。4例因反复阴道出血引产,1例于妊娠早期发现要求流产,1例于妊娠36周剖宫产分娩一活女婴。6例大体病理检查均显示为两个分离的组织,一个为正常胎盘,一个为葡萄胎。正常胎盘绒毛发育良好,葡萄胎绒毛水肿。短串联重复序列(short tandem repeat,STR)基因检测均显示葡萄胎组织为单精空卵(纯合型),符合完全性葡萄胎。随访6例患者均未继发妊娠滋养细胞肿瘤,中位β-hCG转阴的时间为2.5(2~6)个月。结论:CHMCF病例较为罕见,正确诊断对预后有重要临床意义,STR基因检测对诊断有一定帮助。

PAPP-A与P对PHM和稽留流产的早期诊断意义

目的探讨血清孕酮(P)和妊娠相关蛋白-A(PAPP-A)在早期诊断部分性葡萄胎和稽留流产中早期诊断的价值。方法选择确诊的部分性葡萄胎患者20例及稽留流产患者30例,用酶联免疫吸附法检测血清P、PAPP-A水平。结果与宫内早孕组比较,部分性葡萄胎和稽留流产组血清P和PAPP-A水平低于宫内早孕组,差异有统计学意义(P<0.05),部分性葡萄胎组和稽留流产组之间比较,差异无统计学意义(P>0.05);同一孕周时,正常宫内早孕者血清PAPP-A的含量高于部分性葡萄胎患者,且差异有统计学意义(P<0.05)。结论血清孕酮、妊娠相关血浆蛋白A检测有助于部分性葡萄胎和稽留流产的早期诊断。