Early ultrasound diagnosis and follow-up of molar pregnancies
Early ultrasound diagnosis and follow-up of molar pregnancies
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DOI：
10.1046/j.1469-0705.1997.09010017.x
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发表时间：
1997-01-01
影响因子：
7.1
通讯作者：
Nicolaides, KH
中科院分区：
文献类型：
--
作者：
Jauniaux, E;Nicolaides, KH
本研究的目的是探讨超声在鉴别诊断和管理的早期妊娠胎盘磨牙的变化。在妊娠10-14周接受超声检查的妇女中记录10个月内的胎盘特征。在葡萄胎妊娠的病例中，在子宫内获得胎儿核型，如果妊娠继续，则连续测量母体人绒毛膜促性腺激素（hCG）浓度和子宫动脉血流阻力。分娩后对所有病例进行胎盘组织病理学检查。在研究期间，9425名妇女进行了早期扫描，确定了11例葡萄胎妊娠，其中包括1例典型的葡萄胎，4例与正常妊娠共存的葡萄胎，3例部分三倍体葡萄胎和3例部分葡萄胎，其中一例胎儿表现出先天性异常，诊断为Beckwith-Wiedemann综合征。hCG水平高，在所有情况下，除了一个案件的三倍体，并保持在高水平的情况下，其余的妊娠期与胎儿共存的葡萄胎。在这些病例中，子宫动脉阻力正常。目前的数据表明，胎盘超声检查可以正确地识别磨牙的变化，在怀孕早期，连同hCG水平和子宫多普勒测量可以建立在子宫内的各种形式的胎盘磨牙的转变的鉴别诊断。
The objective of this study was to investigate the role of ultrasound in the differential diagnosis and management of early Pregnancies presenting with placental molar changes. Placental features were recorded over a 10-month period in women undergoing ultrasound examination at 10-14 weeks of gestation. rn cases of a molar pregnancy, the fetal karyotype was obtained in utero and, if the pregnancy continued, the maternal concentration of human chorionic gonadotropin (hCG) and uterine artery resistance to flow were measured serially. A histopathological examination of the placenta was performed in all cases after delivery. During the study period, 9425 women had an early scan and 11 molar pregnancies were identified including one classical mole, four hydatidiform moles coexisting with a normal pregnancy, three partial triploid moles and three partial moles associated in one case with a fetus presenting congenital anomalies diagnostic of Beckwith-Wiedemann syndrome. The hCG levels were high in all cases except one case of triploidy and remained high during the rest of the pregnancy in cases of hydatidiform moles coexisting with a fetus. In these cases, the uterine artery resistance was normal. The present data indicate that placental ultrasound examination can correctly identify molar changes in early pregnancy and together with hCG level and uterine Doppler measurements can establish the differential diagnosis in utero of the various forms of placental molar transformations.