完全性葡萄胎与胎儿共存临床研究

    李珠玉陈海天彭软王子莲游泽山

    【摘要】目的探讨完全性葡萄胎与胎儿共存(CMCF)的临床特征及妊娠结局。方法收集并分析6例CMCF的临床资料。结果6例中，体外受精-胚胎移植术后妊娠5例，促排卵治疗后妊娠1例；妊娠中期发现5例，妊娠早期发现1例；双胎之一完全性葡萄胎5例，三胎之一完全性葡萄胎1例；要求继续妊娠1例，要求终止妊娠4例，被迫终止妊娠1例。6例产妇均存活，胎儿存活1例。结论CMCF的发生可能与应用辅助生殖技术相关，其结局取决于病情发展、胎儿染色体及患者意愿。若胎儿染色体正常，且妊娠期间未出现严重母体并发症，有分娩活胎可能，但其继续妊娠的风险评估仍需进一步的研究。

    【关键词】妊娠；完全性葡萄胎；双胎妊娠；多胎妊娠

    收稿日期：(2015-05-23)

    DOI：10.3969/g.issn.0253-9802.2015.10.012

    通讯作者，李洁

    Clinical study of complete hydatidiform mole and co-existing fetusLiZhuyu,ChenHaitian,PengRuan,WangZilian,YouZeshan.DepartmentofObstetricsandGynecology,theFirstAffiliatedHospitalofSunYat-senUniversity,Guangzhou510080,China

    Correspondingauthor,WangZilian,E-mail:wangzilian2005@aliyun.com

    Abstract【】ObjectiveTo explore the clinical characteristics and pregnancy outcomes of complete hydatidiform mole and co-existing fetus (CMCF). MethodsThe data of six CMCF women were analyzed retrospectively. ResultsAmong six CMCF women, five were pregnant after in vitro fertilization and embryo transplantation, and one after ovulation-stimulating treatment. Five patients were diagnosed with CMCF in middle pregnancy and one in early pregnancy. Five cases had twin pregnancy with complete hydatidiform mole and one was triplet pregnanct. One case insisted on continuous pregnancy, four accepted pregnancy termination and one was forced to terminate pregnancy. All six women and one fetus survived. ConclusionsThe incidence of CMCF is probably correlated with the application of assisted reproductive technology. Clinical outcomes depend on disease progression, fetal chromosome and patients’ willingness. If the fetal chromosome is normal and no serious maternal complications occur during pregnancy, the fetus may survive. However, the risk of continuous pregnancy remains to be evaluated. ......