复杂三胎妊娠合并部分葡萄胎和活胎共存的双胞胎:一例在三级护理中心管理的病例报告

Ketki S. Kulkarni, Minal Dhanvij, A. Goel
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引用次数: 0

摘要

有葡萄胎和活胎的妊娠极为罕见,约为2 - 10万分之一。由于不孕症治疗的增加,多胎妊娠正在增加,因此与之相关的并发症也在上升。此外,部分痣伴活胎是一种罕见的实体,文献中只有少数病例报道。本研究的目的是报告一个罕见的病例,并回顾现有的文献,试图制定临床指南。我们报告一例36岁高龄的初产妇,妊娠29.1周体外受精,伴有严重的先兆子痫。在早期的超声扫描报告中,她是三胞胎妊娠,在11周时进行了胎位减少,并减少为双胞胎。做了下段剖宫产,生下了一个1100克的健康男婴。活三胞胎胎盘和胎纸状胎盘(200 g)用细脐带附着于葡萄胎胎和囊泡上娩出。这种困境是继续妊娠还是终止妊娠,因为这是一个需要解决的关键问题。对此类病例的密切监测可以提供最佳结果和预防转移。Kulkarni KS, Dhanvij MP, Goel a .复杂的三胞胎妊娠减少到双胞胎,部分葡萄胎和共存的活胎:一个三级保健中心管理的病例报告。国际不孕胎儿医学杂志2019;10(3):58-62。
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Complicated Triplet Gestation Reduced to Twins with Partial Hydatidiform Mole and a Coexisting Live Fetus: A Case Report Managed in a Tertiary Care Center
Pregnancies with hydatidiform mole and a live fetus are extremely rare, arising in about 1 in 20,000–100,000 pregnancies. Multifetal gestations are increasing due to increase in infertility treatment, and so the complications related to it are on the verge of rising. Also, the partial mole with live fetus is a rare entity, and only few cases are reported in the literature. The objective of the study is reporting a rare case and reviewing the available literature in an attempt to make clinical guidelines. We are reporting a case of 36-year-old, elderly primigravida with in vitro fertilization conception at 29.1 weeks of gestation with severe preeclampsia. She was triplet gestation in early ultrasonography scan reports, and fetal reduction was done at 11 weeks and reduced to twins. A lower segment cesarean section was done, and a healthy male fetus of 1,100 g was delivered. Placenta of the live triplet and the fetus papyraceous (200 g) was delivered with a thin cord attached to hydatidiform molar placenta and vesicles. The dilemma is whether to continue such pregnancy or to terminate it, as it is a critical issue to solve. The watchful monitoring of such cases can provide optimum outcome and prevention of metastasis. How to cite this article: Kulkarni KS, Dhanvij MP, Goel A. Complicated Triplet Gestation Reduced to Twins with Partial Hydatidiform Mole and a Coexisting Live Fetus: A Case Report Managed in a Tertiary Care Center. Int J Infertil Fetal Med 2019;10(3):58–62.
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