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首页> 外文期刊>Taiwanese journal of obstetrics and gynecology >Triplet Pregnancy Complicated with One Hydatidiform Mole and Preeclampsia in a 46,XY Female with Gonadal Dysgenesis
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Triplet Pregnancy Complicated with One Hydatidiform Mole and Preeclampsia in a 46,XY Female with Gonadal Dysgenesis

机译：三联体妊娠并发一名葡萄胎和先兆子痫的46，XY女性性腺发育不全

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摘要

Objective: We present a case of triplet pregnancy with a complete hydatidiform mole, a condition carrying a significant risk to both mother and fetuses and, therefore, raising an important issue on prenatal care. Case Report: A 36-year-old patient with gonadal dysgenesis and a 46,XY karyotype successfully conceived a triplet pregnancy after oocyte donation and in vitro fertilization. At mid-trimester, the pregnancy was seen harboring a hydatidiform mole along with two other fetuses by ultrasound. Fetal karyotypingof both fetuses revealed normal results. Serum human chorionic gonadotropin levels were followed up throughout the remainder of pregnancy. At 33 weeks of gestation, preeclampsia ensued with worsening of maternal renal function and high blood pressure, so cesarean section was arranged to deliver a set of two surviving twins. Prophylactic bilateral gonadectomy was done at the same time to curtail the possibility of future malignancy development. Upon pathologic examination of the placentae, hydropic chorionic villi with central cistern formation and nonpolartrophoblastic hyper-plasia with atypia and necrosis were found, compatible with complete hydatidiform mole. The gonads showed streaks of fibrous tissue, which resembled ovarian stroma and hilus cells, and an unremarkable tube. Maternal serum human chorionic gonadotropin levels declined gradually to normal level at two months after delivery. Conclusion: This is the first report of triplet pregnancy complicated with one complete hydatidiform mole and preeclampsia in a 46,XY female with gonadal dysgenesis. Our case demonstrated that prolonged gestation with both surviving fetuses was possible by applying intensive monitoring of the whole pregnancy.
机译：目的：我们提出了一例三胞胎妊娠并伴有完整的葡萄胎的情况，这种疾病对母亲和胎儿均构成重大风险，因此在产前保健方面引起了重要问题。病例报告：一名36岁的性腺发育不全，46，XY核型的患者在捐卵和体外受精后成功怀孕了三胞胎。在妊娠中期，通过超声检查发现妊娠中有葡萄胎和另外两个胎儿。两个胎儿的胎儿核型分析显示正常结果。在整个怀孕的剩余时间内都对血清人绒毛膜促性腺激素水平进行了跟踪。妊娠33周时，先兆子痫随之而来，其母体肾功能恶化和高血压，因此安排剖宫产以分娩两个幸存的双胞胎。同时进行了预防性双侧性腺切除术，以减少将来发生恶性肿瘤的可能性。在对胎盘进行病理检查后，发现具有中央水箱形成的水性绒毛膜绒毛和具有非典型性和坏死的非极化滋养细胞增生，与完整的葡萄胎相似。性腺显示出纤维组织的条纹，类似于卵巢间质和and细胞，管无明显。分娩后两个月，孕妇血清人绒毛膜促性腺激素水平逐渐下降至正常水平。结论：这是首次向患有性腺发育不全的46，XY女性进行三联体妊娠并伴有完全葡萄胎和先兆子痫的报道。我们的病例表明，通过对整个妊娠进行深入监测，可以使两个存活的胎儿延长妊娠期。

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