Abstract:
Partial hydatidiform mole and coexisting fetus (PHMCF) is a rare condition that presents a dilemma for physicians and the parents of the fetus, particularly when PHMCF is detected during the second trimester of pregnancy. The present study reports a case of PHMCF terminated by induction of labor via administration of Rivanol at 17 weeks. Follow-up measurements of serum β-human chorionic gonadotropin (β-HCG) levels, as well as imaging studies, indicated the presence of persistent trophoblastic disease (PTD) and lung metastases. The patient was therefore admitted for three courses of chemotherapy. Subsequently, the metastases receded and β-HCG levels decreased to within the normal range. The patient demonstrated no disease recurrence for 1 year. Following a review of the relevant literature, to the best of our knowledge, all PHMCF cases terminated by medical induction of labor during the second trimester resulted in the development of PTD and lung metastases. However, three cases of PHMCF that were terminated by caesarean section during the third trimester did not develop PTD or metastases. The present study therefore hypothesized that medical termination may not be a safe therapeutic strategy for the treatment of PHMCF during the second trimester, and that pregnancy should be allowed to continue empirically.
摘要:
部分葡萄胎和共存胎儿(PHMCF)是一种罕见的疾病,给医生和胎儿父母带来了两难的境地。特别是在妊娠中期检测到PHMCF时。本研究报告一例PHMCF在17周时通过利凡诺给药引产而终止。血清β-人绒毛膜促性腺激素(β-HCG)水平的随访测量,以及成像研究,提示存在持续性滋养细胞疾病(PTD)和肺转移。因此,患者接受了三个疗程的化疗。随后,转移灶消退,β-HCG水平降至正常范围.患者1年内无疾病复发。在回顾了相关文献之后,据我们所知,所有在妊娠中期因医学引产而终止的PHMCF病例均导致PTD和肺转移。然而,在妊娠晚期通过剖腹产终止的3例PHMCF未发生PTD或转移.因此,本研究假设医疗终止可能不是妊娠中期PHMCF治疗的安全治疗策略。应该允许怀孕继续凭经验。