PDF(Pubmed)
Abstract：
Pregnancy of unknown location (PUL) is a condition in which a pregnancy test, such as elevation of serum or urine β-human chorionic gonadotrophin (hCG) level, is rendered positive; however, intrauterine or extrauterine pregnancy cannot be confirmed by transvaginal sonography (TVS). Diagnostic dilation and curettage (D&C) or laparoscopy may be performed to search for the pregnancy location. We experienced a case of PUL in which D&C was performed and histological examination revealed a tiny complete hydatidiform mole within the uterine contents. A retrospective review of the clinical course of this case, such as the evaluation of serum β-hCG levels and TVS findings, suggested that this medical entity could be explained by a tiny hydatidiform mole. In PUL, during D&C, when abnormal villi are detected, even if the lesion is tiny, a suspicion of a hydatidiform mole should be considered by the pathologists, and immunostaining and/or chromosome testing/molecular genotyping should be subsequently performed. Whether a tiny hydatidiform mole poses a risk of persistent gestational trophoblastic disease requires further study based on the accumulation of cases. D&C for PUL patients may be a useful procedure to determine such diagnoses and pick up cases.
摘要：
未知位置妊娠（PUL）是妊娠试验的一种情况，如血清或尿液β-人绒毛膜促性腺激素（hCG）水平升高，呈现积极的；然而，经阴道超声检查（TVS）无法确认宫内或宫外孕。可以进行诊断性扩张和刮宫(D&C)或腹腔镜检查以寻找妊娠位置。我们经历了一例PUL，其中进行了D＆C，组织学检查显示子宫内容物中有微小的完整葡萄胎。对该病例的临床过程进行回顾性回顾,如评估血清β-hCG水平和TVS结果，建议这个医学实体可以用一个微小的葡萄胎来解释。在PUL,在D&C期间，当检测到异常绒毛时，即使病变很小，病理学家应该考虑怀疑葡萄胎，随后应进行免疫染色和/或染色体测试/分子基因分型。微小的葡萄胎是否会造成持续性妊娠滋养细胞疾病的风险，需要根据病例的积累进行进一步研究。用于PUL患者的D＆C可能是确定此类诊断和接诊病例的有用程序。
