臨床婦人科産科74巻10号

2020年10月発行

今月の臨床 胎盤・臍帯・羊水異常の徹底理解―病態から診断・治療まで 胎盤

胎児共存奇胎の画像診断と予後

著者： 尾本暁子¹ 碓井宏和¹ 生水真紀夫¹

所属機関： ¹千葉大学医学部附属病院周産期母性科婦人科

ページ範囲：P.994 - P.1000

●胎児共存奇胎では，間葉性異形成胎盤との鑑別が必要である．

●妊娠継続による生児獲得率は40％である．

●妊娠継続には，出血・妊娠高血圧症候群・早産などの母体リスクが伴う．

●続発症の発症率は高く（40％），早期に妊娠を中断しても低下しない．

参考文献

1）尾本暁子，他 : 胎児共存奇胎．周産期医49 : 50-55, 2019

2）Nayeri UA, et al : Systematic review of sonographic findings of placental mesenchymal dysplasia and subsequent pregnancy outcome. Ultrasound Obstet Gynecol 41 : 366-374, 2013

3）Yoneda N, et al : A triploid partial mole placenta from paternal isodisomy with a diploid fetus derived from one sperm and one oocyte may have caused angiogenic imbalance leading to preeclampsia-like symptoms at 19 weeks of gestation. Placenta 34 : 631-634, 2013

4）Kawasaki K, et al : Live-born diploid fetus complicated with partial molar pregnancy presenting with pre-eclampsia, maternal anemia, and seemingly huge placenta : a rare case of confined placental mosaicism and literature review. J Obstet Gynaecol Res 42 : 911-917, 2016

5）Himoto Y, er al : Prenatal differential diagnosis of complete hydatidiform mole with a twin live fetus and placental mesenchymal dysplasia by magnetic resonance imaging. J Obstet Gynaecol Res 40 : 1894-1900, 2014

6）Saito Y, et al : Early pregnancy-associated cardiomyopathy complicated with a complete hydatidiform mole coexistent with a live fetus and exacerbated by induced abortion. Int J Cardiol 198 : 170-173, 2015

7）Lin LH, et al : Multiple pregnancies with complete mole and coexisting normal fetus in North and South America : A retrospective multicenter cohort and literature review. Gynecol Oncol 145 : 88-95, 2017

8）Sebire NJ, et al : Outcome of twin pregnancies with complete hydatidiform mole and healthy co-twin. Lancet 359 : 2165-2166, 2002

9）Lee SW, et al : Clinical findings of multiple pregnancy with a complete hydatidiform mole and coexisting fetus. J Ultrasound Med 29 : 271-280, 2010

10）八代憲司，他 : 胎児共存奇胎において胞状奇胎の局在が周産期予後に及ぼす影響．日周産期・新生児会誌55 : 958-963, 2019

11）日本産科婦人科学会，他 : 絨毛性疾患取扱い規約，第3版．金原出版，2011

12）FIGO Oncology Committee : FIGO staging for gestational trophoblastic neoplasia 2000. FIGO Oncology Committee. Int J Gynaecol Obstet 77 : 285-287, 2002

13）松井英雄，他 : 胎児共存奇胎の管理―全国集計の結果と文献的考察．日産婦会誌51 : 1-8, 1999