Abstract:
Complete hydatidiform (also referred to as hydatiform) mole with coexisting live fetus is an exceedingly rare event. The fetus usually has a normal karyotype, and approximately 25-40% chance of survival, if pregnancy is allowed to continue until reasonable fetal lung maturity is achieved. However, risk of maternal complications including preeclampsia and subsequent trophoblastic disease are significant. We report a case of a 19-year-old primigravida, at 25 weeks gestation with a complete hydatidiform mole and a coexisting live fetus. She developed severe preeclampsia with uncontrolled hypertension, and pregnancy was terminated by caesarean section, after a short course of dexamethasone to accelerate fetal lung maturity. A morphologically normal live female fetus and placenta were delivered without complications, along with a separate mass of complete mole. The postpartum course was complicated by uterine choriocarcinoma with metastases to lung and left kidney, which responded to chemotherapy. Our case is a rare example of a twin gestation composed of a complete hydatidiform mole with a coexisting live fetus, and illustrates the associated spectrum of maternal complications that mandate close pre- and post-natal surveillance.
摘要:
完全葡萄胎(也称为葡萄胎)与共存的活胎是非常罕见的事件。胎儿通常具有正常的核型,大约有25-40%的存活率,如果允许继续怀孕,直到达到合理的胎儿肺成熟。然而,产妇并发症包括先兆子痫和随后的滋养细胞疾病的风险是显著的.我们报告了一个19岁的primigravida病例,妊娠25周时,有完整的葡萄胎和共存的活胎儿。她出现了严重的先兆子痫,高血压失控,剖腹产终止了妊娠,经过短疗程的地塞米松加速胎肺成熟。一个形态正常的活的女性胎儿和胎盘分娩,没有并发症。还有一团完整的痣。产后病程并发子宫绒毛膜癌并转移到肺和左肾,对化疗有反应。我们的案例是一个罕见的双胎妊娠,由一个完整的葡萄胎和一个共存的活胎组成,并说明了需要密切产前和产后监测的产妇并发症的相关范围。