【摘要】：目的探討多胎妊娠合并葡萄胎的臨床特征。方法收集12例多胎妊娠合并葡萄胎病例資料,分析其臨床特征、超聲檢查結果、妊娠結局等。結果 12例患者中無一例自然妊娠,2例行促排卵治療后妊娠,其余10例均行體外受精-胚胎移植(IVF-ET)后妊娠。9例為雙胎妊娠合并葡萄胎,2例為3胎妊娠合并葡萄胎,1例為4胎妊娠合并葡萄胎。12例患者中,4例出現(xiàn)妊娠劇吐,10例有嚴重陰道流血,2例出現(xiàn)腹痛,1例并發(fā)子癇前期、甲狀腺功能亢進癥及轉氨酶升高,2例并發(fā)亞臨床甲狀腺功能亢進,3例并發(fā)甲狀腺功能亢進癥,6例甲狀腺功能正常。1例足月剖宮產(chǎn)活產(chǎn)一男嬰,其余11例均終止妊娠。2例于清宮術后血人絨毛膜促性腺激素(h CG)不降反升和持續(xù)平臺期,疑為持續(xù)性滋養(yǎng)細胞疾病,給予單藥化療,最后隨訪至正常。結論多胎妊娠合并葡萄胎的并發(fā)癥多見,且有發(fā)生持續(xù)性滋養(yǎng)細胞疾病的風險。多數(shù)患者終止妊娠,當未出現(xiàn)明顯孕婦及胎兒并發(fā)癥及患者有繼續(xù)妊娠的愿望時可在密切監(jiān)測繼續(xù)妊娠。
[Abstract]:Objective to investigate the clinical features of multiple pregnancy with hydatidiform mole. Methods 12 cases of multiple pregnancy complicated with hydatidiform mole were collected and their clinical features, ultrasonic findings and pregnancy outcome were analyzed. Results none of the 12 patients had spontaneous pregnancy and 2 cases had pregnancy after ovulation promotion therapy. The remaining 10 cases were treated with in vitro fertilization and embryo transfer (IVF-ET). 9 cases of pregnancy were twin pregnancy combined with hydatidiform mole. 2 cases were 3 pregnancies with hydatidiform mole. 1 case was 4 cases of pregnancy with hydatidiform mole. 12 cases were pregnant with hyperemesis in 10 cases. Severe vaginal bleeding occurred in 2 cases, abdominal pain occurred in 1 case, and preeclampsia occurred in 1 case. Hyperthyroidism and elevated transaminase in 2 cases with subclinical hyperthyroidism 3 cases with hyperthyroidism 6 cases with normal thyroid function 1 cases with full-term cesarean section gave birth to a male baby. All the other 11 cases terminated pregnancy in 2 cases. The serum human chorionic gonadotropin (h CG) did not decrease and rise in the stage of persistent plateau, suspected as persistent trophoblastic disease, received single drug chemotherapy, and was followed up to normal at last. Conclusion the complications of multiple pregnancy complicated with hydatidiform mole are common and at risk of persistent trophoblastic disease. Most patients terminate pregnancy and continue pregnancy under close monitoring when there are no obvious pregnancy and fetal complications and the patient has the desire to continue pregnancy.
【作者單位】： 中山大學附屬第一醫(yī)院婦產(chǎn)科;中山大學附屬第一醫(yī)院超聲科;
【分類號】：R714.2;R737.33
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本文編號：2200577