完全性葡萄胎与胎儿共存一例并文献复习

doi:10.12280/gjfckx.20230567

摘要/Abstract

摘要：

葡萄胎与胎儿共存（hydatidiform mole and co-existing fetus，HMCF）是产科的罕见疾病，包括完全性葡萄胎与胎儿共存（complete hydatidiform mole with co-existing fetus，CHMCF）和部分性葡萄胎与胎儿共存（partial hydatidiform mole with co-existing fetus，PHMCF）。报道1例CHMCF病例通过妊娠期连续监测甲状腺功能、人绒毛膜促性腺激素和胎儿状况妊娠至37周，剖宫产分娩一活婴。CHMCF是一种临床罕见的高风险疾病，妊娠期应联合超声、磁共振成像和染色体核型分析仔细鉴别诊断，并在有产前诊断和妇科肿瘤中心的机构严密监测妊娠、分娩及产后随访。

关键词: 妊娠，双胎, 葡萄胎, 妊娠滋养细胞疾病, 核型分析, 完全性葡萄胎与胎儿共存

Abstract:

Hydatidiform mole and co-existing fetus (HMCF) is a rare obstetric disease, including complete hydatidiform mole with co-existing fetus (CHMCF) and partial hydatidiform mole with a co-existing fetus (PHMCF). A case of CHMCF was reported by continuous monitoring of thyroid function, human chorionic gonadotropin and fetal status during pregnancy up to 37 weeks of gestation and delivery of a live infant by cesarean section. CHMCF is a clinically rare and high-risk disease. Therefore, pregnancy, parturition and postpartum follow-up should be carefully diagnosed and closely monitored through ultrasound, magnetic resonance imaging (MRI) and chromosomal karyotype analysis in institutions with prenatal diagnosis and gynecological oncology centers.

Key words: Pregnancy, twin, Hydatidiform mole, Gestational trophoblastic disease, Karyotyping, Complete hydatidiform mole with co-existing fetus

李剑, 王冠. 完全性葡萄胎与胎儿共存一例并文献复习[J]. 国际妇产科学杂志, 2023, 50(5): 522-525.

LI Jian, WANG Guan. Complete Hydatidiform Mole with Co-Existing Fetus: A Case Report and Literature Review[J]. Journal of International Obstetrics and Gynecology, 2023, 50(5): 522-525.

图/表 4

图1 妊娠31周盆腔超声图注：A为CHMCF超声图，红色箭头指示葡萄胎组织；B为CHMCF彩色多普勒超声图。

图2 妊娠31周盆腔MRI图注：A为失状面；B为横断面。红色箭头为完全性葡萄胎组织。

图3 完全性葡萄胎组织的病理图（HE染色×100）注：绒毛滋养细胞显著增生，标尺=100 μm。

图4 完全性葡萄胎组织的免疫组织化学图（×100）注：A Ki-67（90%+）；B P57阴性。提示完全性葡萄胎。标尺=100 μm。

参考文献 11

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