国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (4): 405-409.doi: 10.12280/gjfckx.20250031

• 产科生理及产科疾病:病例报告 • 上一篇    下一篇

胎盘部位超常反应合并梅毒感染一例

侯刘静, 周梦莹, 韦玉艳, 姜景岩()   

  1. 250117 济南,山东第一医科大学(山东省医学科学院)研究生部(侯刘静); 山东第一医科大学附属中心医院妇科(周梦莹,韦玉艳,姜景岩)
  • 收稿日期:2025-01-10 出版日期:2025-08-15 发布日期:2025-09-08
  • 通讯作者: 姜景岩,E-mail:1503358643@qq.com

Exaggerated Placental Site with Concurrent Syphilis Infection: A Case Report

HOU Liu-jing, ZHOU Meng-ying, WEI Yu-yan, JIANG Jing-yan()   

  1. Department of Postgraduate, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China (HOU Liu-jing); Department of Gynecology, Central Hospital Affiliated to Shandong First Medical University, Jinan 250014, China (ZHOU Meng-ying, WEI Yu-yan, JIANG Jing-yan)
  • Received:2025-01-10 Published:2025-08-15 Online:2025-09-08
  • Contact: JIANG Jing-yan, E-mail: 1503358643@qq.com

摘要:

胎盘部位超常反应(exaggerated placental site,EPS)是一种少见的与妊娠有关的胎盘种植部位中间型滋养细胞(implantation site intermediate trophoblast,ISIT)非肿瘤性高度增生的良性病变,常发生于分娩及流产后,患者主要临床表现为无诱因的顽固性阴道出血。该病主要依靠病理确诊,病理特征为中间型滋养细胞较多地浸润于子宫蜕膜及平滑肌组织。报告1例药物流产合并梅毒感染患者流产后出现不规则阴道出血伴间断性下腹痛50 d,超声示宫腔残留累及肌层伴丰富血流信号,血人绒毛膜促性腺激素β亚单位(β-human chorionic gonadotropin,β-hCG)升高。行超声监测下宫腔镜残留胚物电切术,术后病理示胎盘部位超常反应。随访患者血β-hCG降至正常,恢复月经来潮,预后好。

关键词: 流产, 超声检查, 梅毒, 病例报告, 胎盘部位超常反应

Abstract:

Exaggerated placental site (EPS) is a rare benign, non-neoplastic condition characterized by excessive proliferation of implantation site intermediate trophoblasts (ISITs) at the placental implantation site, typically occurring after delivery or abortion. The primary clinical manifestation of patients is persistent unexplained vaginal bleeding. Diagnosis is primarily pathological, with key features showing extensive infiltration of intermediate trophoblast cells into the uterine decidua and smooth muscle tissue. A case of patient with medication abortion and syphilis infection who presented with irregular vaginal bleeding and intermittent lower abdominal pain for 50 days post-abortion was reported. Ultrasound revealed retained products of conception involving the myometrium with rich blood flow signals, along with elevated serum β-human chorionic gonadotropin (β-hCG) levels. The patient underwent hysteroscopic resection of residual conception products under ultrasound guidance. Postoperative pathology confirmed EPS. Follow-up showed normalization of β-hCG levels, resumption of menstruation, and favorable prognosis.

Key words: Abortion, Ultrasonography, Syphilis, Case reports, Exaggerated placental site