国际生殖健康/计划生育 ›› 2019, Vol. 38 ›› Issue (4): 296-300.

• 病例报告 • 上一篇    下一篇

体外受精-胚胎移植后双胎妊娠之一完全性葡萄胎一例报道

方昉,郭哲璇,廖慧慧   

  1. 510405 广州中医药大学第一临床医学院(方昉,郭哲璇);广州中医药大学第一附属医院(廖慧慧)
  • 收稿日期:2019-03-21 修回日期:2019-04-15 出版日期:2019-07-15 发布日期:2019-07-15
  • 通讯作者: 廖慧慧,E-mail:61008926@qq.com E-mail:61008926@qq.com;2404277483@qq.com

A Case Report of Complete Hydatidiform Mole in Twin Pregnancy after IVF-ET

FANG Fang,GUO Zhe-xuan,LIAO Hui-hui   

  1. The First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,China(FANG Fang,GUO Zhe-xuan);The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China(LIAO Hui-hui)
  • Received:2019-03-21 Revised:2019-04-15 Published:2019-07-15 Online:2019-07-15
  • Contact: LIAO Hui-hui,E-mail:61008926@qq.com E-mail:61008926@qq.com;2404277483@qq.com

摘要: 分析1例经体外受精-胚胎移植(IVF-ET)后双胎妊娠之一完全性葡萄胎的孕妇临床资料。该患者为双胎妊娠,在妊娠早期出现大量阴道出血,因B型超声(B超)尚未出现典型葡萄胎表现而曾误诊为先兆流产,予安胎治疗。后结合人绒毛膜促性腺激素(hCG)数值及B超结果诊断为双胎妊娠合并葡萄胎,予B超引导下清宫。查流产组织病理符合部分性葡萄胎改变,但染色体检查结果提示为完全性葡萄胎。术后配合中医中药治疗,患者hCG下降明显,随访至今未见明显异常。产前诊断对该病极为重要,病理诊断尚不能成为鉴别完全性葡萄胎与部分性葡萄胎的诊断标准。对于双胎妊娠合并葡萄胎的处理,应综合考虑,原则上双胎之一部分性葡萄胎应及时终止妊娠,双胎之一完全性葡萄胎应制定个体化的诊疗方案。

关键词: 妊娠, 双胎, 葡萄胎, 生殖技术, 辅助, 病例报告

Abstract: The clinical data of a pregnant woman with a complete hydatidiform mole after in vitro fertilization and embryo transfer (IVF-ET) were retrospectively analyzed. This patient was a twin pregnancy with a large amount of vaginal bleeding in the early stage of pregnancy. She had been initially misdiagnosed as threatened abortion due to the absence of typical manifestations of hydatidiform mole by B-mode ultrasonography. After one month of treatment, the diagnosis of twin pregnancy with a hydatidiform mole was made by the result of B-mode ultrasonography combined with the value of human chorionic gonadotropin (hCG). The uterine curettage was performed under the guidance of B-mode ultrasonography. Histopathological examination showed a partial hydatidiform mole, and chromosome examination showed a complete hydatidiform mole. After operation, with the treatment of traditional Chinese medicine, the level of hCG decreased significantly, and the patient did not report any symptoms in the follow-up. Prenatal diagnosis is extremely important for the diagnosis. The pathological diagnosis cannot be the diagnostic criteria for identifying complete moles and partial moles. For the treatment of a twin pregnancy with a hydatidiform mole, comprehensive consideration should be suggested. In principle, the pregnancy should be terminated in time for one partial hydatidiform mole of the twin, and the individualized diagnosis and treatment should be suggested for one complete hydatidiform mole of the twin.

Key words: Pregnancy, twin, Hydatidiform mole, Reproductive techniques, assisted, Case reports