Second tirmester of complete hydatidiform mole and coexisting fetus secondary distant metastasis:a case report and literature review
Objective To investigate the clinical characteristics and diagnosis and treatment of secondary distant metastasis of complete hydatidiform mole and coexisting fetus(CHMCF)in second trimester.Methods The diagnosis,treatment and follow-up condition of a patient with CHMCF admitted to Hubei Maternal and Child Health Care Hospital in July 2021 were analyzed retrospectively,and the diagnosis and treatment strategy was discussed based on literature review.Results This case was admitted to the hospital for prenatal care treatment due to threatened miscarriage.Color Doppler ultrasound revealed a honeycomb like anechoic area in the uterine cavity in addition to normal fetal placental tissue.Drug induced labor was performed,and CHMCF was confirmed after operation.The decrease of blood β-human chorionic gonadotropin(β-HCG)was poor during follow-up period,and there were small metastases in the lungs.After receiving one cycle of methotrexate chemotherapy,it decreased to negative,and there was no recurrence after more than six months of follow-up.Conclusions CHMCF is a high-risk pregnancy.Ultrasound combined with blood β-HCG dynamic monitoring is of great significance for the early identification of CHMCF.Meanwhile,perfect genetic screening is of directive significance for clinical management and prognosis of CHMCF.In clinical management,individual diagnosis and treatment plan should be developed based on the presence or absence of prenatal maternal complications,the increasing trend of blood β-HCG and the patient's tolerance to the risk of continuing pregnancy.In addition,close follow-up after termination of pregnancy is essential to optimize maternal and fetal outcomes.
万方数据
维普
