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Complete Hydatidiform Mole: A case report
完全性妊娠葡萄胎：一病例報告
摘要
一位15 歲未婚初次懷孕少女，因疑似罹患妊娠葡萄胎而經他院轉送本院。早在懷孕初期，已開始出現間斷性輕度子宮出血。當時，其血清人類絨毛膜性腺激素（hCG）達91,816 mIU/ml。轉診本院後，更高達1,407,359 mIU/ml，經陰道超音波發現子宮腔內有高回音囊狀妊娠腫塊，超音波像類似瑞士乳酪型狀，因此診斷為妊娠葡萄胎。據此診斷，給予子宮內容物刮除術，但未開立預防妊娠滋胚層腫瘤之化學治療藥物。手術後，無任何併發症。組織病理學報告證實為完全性葡萄胎。術後其hCG值穩定下降，且於術後30 天達到正常值。術後17 個月，她如願生下一位健康的足月女嬰。故針對年輕孕婦妊娠期前半段之胚胎疾病做鑑別診斷時，應想到是否有葡萄胎之可能性。及早診斷出葡萄胎並加以治療，有利於臨床之治療結果。
並列摘要
A 15-year-old single primigravida was transferred to our hospital for medical management of a presumed molar pregnancy. She presented intermittent uterine bleeding starting early in the first trimester. Her serum human chorionic gonadotropin (hCG) concentration was 91,816 mIU/ml and reached 1,407,359 mIU/ml upon admission. Transvaginal ultrasound revealed an enlarged uterus with “swiss cheese” endometrium, hyperechoic cystic elements, and absence of the embryo in the uterine cavity. Suction curettage was performed for molar pregnancy. No prophylactic adjuvant chemotherapy was prescribed and no postoperative complication was encountered. The histopathological report indicated features of complete hydatidiform mole (CHM). The patient’s hCG value decreased steadily postoperatively and reached the normal range within 30 days. Seventeen months postoperatively, she delivered a healthy full-term female infant. Gestational trophoblastic disease should be considered in the differential diagnosis of young pregnant women that present with such symptoms. Early detection and treatment of CHM improve the clinical outcome.