【摘要】：目的分析雙胎妊娠完全性葡萄胎與正常胎兒共存病例的臨床資料,探討繼續(xù)妊娠及終止妊娠對母親和胎兒的影響及風險。方法應(yīng)用"雙胎妊娠完全性葡萄胎和胎兒同存"關(guān)鍵詞在中國知網(wǎng)(CNKI)數(shù)據(jù)庫和萬方數(shù)據(jù)庫檢索1982年1月至2013年12月發(fā)表文獻。共檢索32例報道,回顧性分析32例患者及北京大學人民醫(yī)院2例患者的臨床資料,其中20例患者在早孕和中孕期終止妊娠(A組,28孕周),14例患者要求繼續(xù)妊娠至晚孕期(B組,≥28孕周),比較兩組患者的臨床特點和發(fā)生持續(xù)性滋養(yǎng)細胞疾病的風險。結(jié)果 A組中17例(17/20)、B組中12例(12/14)在終止妊娠前超聲檢查提示完全性葡萄胎和正常胎兒共存。A組中10例(10/20)、B組中7例(7/14)進行羊膜腔穿刺或絨毛活檢行細胞遺傳學檢測明確診斷。34例患者常見臨床癥狀是陰道出血;A組中4例、B組中3例發(fā)生子癇前期;5例(A組3例,B組2例)發(fā)生持續(xù)性滋養(yǎng)細胞疾病,均于孕期發(fā)生重度子癇前期,并因此結(jié)束妊娠。10例患者通過促排卵受孕,其中A組8例,B組2例。5例持續(xù)性滋養(yǎng)細胞疾病患者中,2例通過促排卵受孕。結(jié)論雙胎妊娠完全性葡萄胎與正常胎兒共存患者若發(fā)生子癇前期提示預(yù)后不良,持續(xù)性滋養(yǎng)細胞疾病的發(fā)生率升高。促排卵可能增加此病的發(fā)生。產(chǎn)前確診后,若孕婦無其他嚴重產(chǎn)科合并癥,繼續(xù)妊娠并不增加持續(xù)性滋養(yǎng)細胞疾病的發(fā)生率。
[Abstract]:Objective to analyze the clinical data of co-existence of complete hydatidiform mole and normal fetus in twin pregnancy and to explore the influence and risk of continuing pregnancy and termination of pregnancy on mother and fetus. Methods the keywords "complete hydatidiform mole and fetal simultaneous survival in twin pregnancy" were used to search the literatures published from January 1982 to December 2013 in (CNKI) database and Wanfang database. The clinical data of 32 patients and 2 patients in Peking University people's Hospital were retrospectively analyzed. Among them, 20 patients terminated pregnancy during the first and second trimester of pregnancy (Group A, 28 weeks of gestation). Fourteen patients were asked to continue pregnancy to the third trimester (group B, 鈮，

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