中国医学前沿杂志（电子版）2025，Vol.17Issue(9)：39-44,6.DOI:10.12037/YXQY.2025.09-07
宫内妊娠合并葡萄胎6例临床分析
Clinical analysis of six cases of hydatidiform mole with coexisting fetus
摘要
Abstract
Objective Six patients with hydatidiform mole with coexisting fetus were regarded as observers in this study,and their processes of diagnosis and treatment were analyzed,so as to improve the understanding of this disease.Methods Six patients with hydatidiform mole with coexisting fetus who are treated in Beijing Obstetrics and Gynecology Hospital were included,and their diagnosis and treatment processes were reviewed to analyze its pregnancy management.Results Four cases of intrauterine pregnancy complicated with partial hydatidiform mole and two cases of intrauterine pregnancy complicated with complete hydatidiform mole were included.Among them,four cases were achieved through natural conception and two cases through assisted reproduction.The age of the 6 patients was 30.8±5.2 years,and the average gestational age at diagnosis was 18.5±2.8 weeks.Among them,3 cases presented with repeated vaginal bleeding in the early pregnancy stage;2 cases had gestational hypertension disorders,1 case had proteinuria during pregnancy,1 case had fetal growth restriction,and 1 case had premature rupture of membranes.The ultrasound diagnosis indicated that the average diameter of the hydatidiform mole tissue was approximately 11.5 cm.The blood β-HCG level of all patients was>70,000 mU/ml.Two cases underwent invasive prenatal diagnosis,but no clear abnormalities were indicated.Four cases underwent histopathological examination.One case did not undergo the examination due to personal reasons.One case had the hydatidiform mole tissue naturally regress during the late pregnancy.Three cases chose to continue the pregnancy.Among them,two cases gave birth to live babies,and one case had a stillbirth during the continuation of the pregnancy and underwent labor induction with rivanol.Three patients chose to terminate the pregnancy.One case underwent carboprost induction plus curettage,one case had a natural miscarriage,and one case underwent labor induction with rivanol.Conclusions Hydatidiform mole with coexisting fetus is a rare obstetric complication,and the clear diagnosis is essential for its clinical decision-making.Its pregnancy management should comprehensively consider the fetal and maternal situation and the family wish.For patients electing to pursue further pregnancies,it is emphasized that the importance of multidisciplinary collaboration and monitoring during pregnancy.The selection of pregnancy termination methods is determined by gestational age.During the second trimester,options may include intra-amniotic rivanol injection for labor induction or prostaglandin-based pharmacologic labor induction;in the third trimester,cesarean section or vaginal delivery can be considered.关键词
部分性葡萄胎伴活胎/完全性葡萄胎伴活胎/妊娠期管理Key words
Partial hydatidiform mole with coexisting fetus/Complete hydatidiform mole with coexisting fetus/Pregnancy management引用本文复制引用
叶艳箐,石俊霞..宫内妊娠合并葡萄胎6例临床分析[J].中国医学前沿杂志（电子版）,2025,17(9):39-44,6.基金项目
北京市科学技术委员会首都临床特色诊疗技术研究及转化应用项目(Z221100007422086) Beijing Municipal Science&Technology Commission(Z221100007422086) （Z221100007422086）
