fa بارداری دوقلو با یک جنین و بارداری مولار: گزارش یک مورد پزشکی- زنان و زایمان Medicine - Obstetrics and Gynecology گزارش مورد case report <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="FA" style="font-family:" zar="">زمینه و هدف:</span></b><span b="" lang="AR-SA" style="font-family:" zar=""> بیماری</span> <span b="" lang="AR-SA" style="font-family:" zar="">تروفوبلاستیک</span> <span b="" lang="AR-SA" style="font-family:" zar="">حاملگی</span> <span b="" lang="AR-SA" style="font-family:" zar="">طیف</span> <span b="" lang="AR-SA" style="font-family:" zar="">وسیعی</span> <span b="" lang="AR-SA" style="font-family:" zar="">از</span> <span b="" lang="AR-SA" style="font-family:" zar="">تومورهای مربوط</span> <span b="" lang="AR-SA" style="font-family:" zar="">به</span> <span b="" lang="AR-SA" style="font-family:" zar="">رحم،</span> <span b="" lang="AR-SA" style="font-family:" zar="">شامل</span> <span b="" lang="AR-SA" style="font-family:" zar="">مول</span> <span b="" lang="AR-SA" style="font-family:" zar="">هیداتیفرم</span> <span b="" lang="AR-SA" style="font-family:" zar="">کامل</span> <span b="" lang="AR-SA" style="font-family:" zar="">و</span> <span b="" lang="AR-SA" style="font-family:" zar="">ناکامل،</span> <span b="" lang="AR-SA" style="font-family:" zar="">تومور تروفوبلاستیک</span> <span b="" lang="AR-SA" style="font-family:" zar="">محل</span> <span b="" lang="AR-SA" style="font-family:" zar="">جفت</span> <span b="" lang="AR-SA" style="font-family:" zar="">و</span> <span b="" lang="AR-SA" style="font-family:" zar="">کوریوکارسینوم</span> <span b="" lang="AR-SA" style="font-family:" zar="">می</span> <span b="" lang="AR-SA" style="font-family:" zar="">باشد</span> <span b="" lang="AR-SA" style="font-family:" zar="">که</span> <span b="" lang="AR-SA" style="font-family:" zar="">تمایلات تهاجم</span> <span b="" lang="AR-SA" style="font-family:" zar="">موضعی</span> <span b="" lang="AR-SA" style="font-family:" zar="">و</span> <span b="" lang="AR-SA" style="font-family:" zar="">متاستازی</span> <span b="" lang="AR-SA" style="font-family:" zar="">متفاوتی</span> <span b="" lang="AR-SA" style="font-family:" zar="">دارند</span><span b="" lang="FA" style="font-family:" zar=""> (1). دراین مطالعه یک مورد حاملگی دو قلویی، با یک جنین و حاملگی مولار در خانم باردار ۴۰ ساله را گزارش می شود.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="FA" style="font-family:" zar="">گزارش مورد:</span></b><span b="" lang="FA" style="font-family:" zar=""> بیمار خانم 40 ساله با بارداری 17 هفته که با شکایت تنگی نفس، سردرد و فشار خون بالا مراجعه کرده بود. با توجه به سونوگرافی جنین با </span><span dir="LTR" style="font-size:11.0pt">Fetal heart rate=110</span><span b="" lang="FA" style="font-family:" zar="">، سایز جفت بسیار بزرگتر از حد نرمال و دارای نواحی کیستیک می باشد. برای مریض تشخیص حاملگی دوقلو با یک جنین و حاملگی مولار داده شد و هیستروتومی اورژانسی برای مریض انجام شد. بیمار بعد از یک هفته با حال عمومی خوب و توصیه به انجام تیتراژ هفتگی</span><span dir="LTR" style="font-size:11.0pt">Human</span> <span dir="LTR" style="font-size:11.0pt">chorionic gonadotropin</span> <a href="https://en.wikipedia.org/wiki/Human_chorionic_gonadotropin" style="color:#0563c1; text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none">&beta;</span></span></a>&nbsp;<span b="" lang="AR-SA" style="font-family:" zar="">و کنترل فشار خون از بیمارستان ترخیص شد</span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" style="font-family:" zar="">&nbsp;نتیجه گیری:</span></b><span b="" lang="AR-SA" style="font-family:" zar=""> حاملگی</span> <span b="" lang="AR-SA" style="font-family:" zar="">مولار</span> <span b="" lang="AR-SA" style="font-family:" zar="">توسط</span> <span b="" lang="AR-SA" style="font-family:" zar="">سونوگرافی</span> <span b="" lang="AR-SA" style="font-family:" zar="">و</span> <span b="" lang="AR-SA" style="font-family:" zar="">اندازه</span> <span b="" lang="AR-SA" style="font-family:" zar="">گیری &nbsp;</span>&nbsp;<span dir="LTR" style="font-size:11.0pt">&beta;HCG</span><span b="" lang="AR-SA" style="font-family:" zar="">سرم</span> <span b="" lang="AR-SA" style="font-family:" zar="">تشخیص</span> <span b="" lang="AR-SA" style="font-family:" zar="">داده</span> <span b="" lang="AR-SA" style="font-family:" zar="">می</span> <span b="" lang="AR-SA" style="font-family:" zar="">شود</span><span b="" lang="FA" style="font-family:" zar="">.</span><span b="" lang="AR-SA" style="font-family:" zar=""> با</span> <span b="" lang="AR-SA" style="font-family:" zar="">توجه</span> <span b="" lang="AR-SA" style="font-family:" zar="">به</span> <span b="" lang="AR-SA" style="font-family:" zar="">این</span> <span b="" lang="AR-SA" style="font-family:" zar="">که</span> <span b="" lang="AR-SA" style="font-family:" zar="">عوارض</span> <span b="" lang="AR-SA" style="font-family:" zar="">حاملگی</span> <span b="" lang="AR-SA" style="font-family:" zar="">اعم</span> <span b="" lang="AR-SA" style="font-family:" zar="">از</span> <span b="" lang="AR-SA" style="font-family:" zar="">فشارخون</span> <span b="" lang="AR-SA" style="font-family:" zar="">بارداری</span> <span b="" lang="AR-SA" style="font-family:" zar="">و عوارض</span> <span b="" lang="AR-SA" style="font-family:" zar="">متابولیک</span> <span b="" lang="AR-SA" style="font-family:" zar="">مانند</span> <span b="" lang="AR-SA" style="font-family:" zar="">پرکاری</span> <span b="" lang="AR-SA" style="font-family:" zar="">تیرویید</span> <span b="" lang="AR-SA" style="font-family:" zar="">و</span> <span b="" lang="AR-SA" style="font-family:" zar="">نیز</span> <span b="" lang="AR-SA" style="font-family:" zar="">خون</span> <span b="" lang="AR-SA" style="font-family:" zar="">ریزی</span> <span b="" lang="AR-SA" style="font-family:" zar="">به</span> <span b="" lang="AR-SA" style="font-family:" zar="">دنبال</span> <span b="" lang="AR-SA" style="font-family:" zar="">این گونه</span> <span b="" lang="AR-SA" style="font-family:" zar="">بارداری</span> <span b="" lang="AR-SA" style="font-family:" zar="">ها</span> <span b="" lang="AR-SA" style="font-family:" zar="">افزایش</span> <span b="" lang="AR-SA" style="font-family:" zar="">می</span> <span b="" lang="AR-SA" style="font-family:" zar="">یابد</span> <span b="" lang="AR-SA" style="font-family:" zar="">تشخیص</span> <span b="" lang="AR-SA" style="font-family:" zar="">و</span> <span b="" lang="AR-SA" style="font-family:" zar="">درمان</span> <span b="" lang="AR-SA" style="font-family:" zar="">زودرس</span> <span b="" lang="AR-SA" style="font-family:" zar="">جهت کاهش</span> <span b="" lang="AR-SA" style="font-family:" zar="">مرگ</span> <span b="" lang="AR-SA" style="font-family:" zar="">و</span> <span b="" lang="AR-SA" style="font-family:" zar="">میر</span> <span b="" lang="AR-SA" style="font-family:" zar="">مادری</span> <span b="" lang="AR-SA" style="font-family:" zar="">بسیار</span> <span b="" lang="AR-SA" style="font-family:" zar="">ارزشمند</span> <span b="" lang="AR-SA" style="font-family:" zar="">است.</span> <span b="" lang="AR-SA" style="font-family:" zar="">به</span> <span b="" lang="AR-SA" style="font-family:" zar="">علاوه</span> <span b="" lang="AR-SA" style="font-family:" zar="">بعد</span> <span b="" lang="AR-SA" style="font-family:" zar="">از</span> <span b="" lang="AR-SA" style="font-family:" zar="">ختم این</span> <span b="" lang="AR-SA" style="font-family:" zar="">گونه</span> <span b="" lang="AR-SA" style="font-family:" zar="">حاملگی</span> <span b="" lang="AR-SA" style="font-family:" zar="">ها</span> <span b="" lang="AR-SA" style="font-family:" zar="">بررسی</span> <span b="" lang="AR-SA" style="font-family:" zar="">جهت</span> <span b="" lang="AR-SA" style="font-family:" zar="">تشخیص</span> <span b="" lang="AR-SA" style="font-family:" zar="">زودرس</span> <span b="" lang="AR-SA" style="font-family:" zar="">تو</span> <span b="" lang="AR-SA" style="font-family:" zar="">مورهای تروفوبلاستیک</span> <span b="" lang="AR-SA" style="font-family:" zar="">بسیار</span> <span b="" lang="AR-SA" style="font-family:" zar="">مهم</span> <span b="" lang="AR-SA" style="font-family:" zar="">است.</span></span></span></span></span><br> <br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span style="font-family:"B Zar"" lang="FA"></span></span></span></span></span> <div> <hr align="left" class="msocomoff" size="1" width="33%" ></div> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Background and Aim</b>: Gestational trophoblastic disease consists of a wide range of tumors related to the uterus, including complete and incomplete hydatidiform mole, placental trophoblastic tumor, and choriocarcinoma, which have different tendencies to local invasion and metastasis. In this study, we report a case of twin pregnancy with one fetus and a concomitant mole in a 40-year-old woman.</span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Case report</b>: A 40-year-old woman at 17-week of pregnancy referred with complaints of shortness of breath, headache and high blood pressure. Fetal heart rate was 110. According to the ultrasound of the fetus, the size of the placenta was much larger than normal and had cystic areas. The patient was diagnosed as a case of twin pregnancy with one fetus and a concomitant mole. Emergency hysterotomy was performed. The patient was discharged from the hospital after one week in good general condition and recommended to check weekly &beta;HCG titer test and control blood pressure.</span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>conclusion:</b> Molar pregnancy is diagnosed by abdominal ultrasound and serum &beta;HCG measurement. Considering pregnancy complications such as gestational hypertension and metabolic disorders such as hyperthyroidism and bleeding which can increase after such pregnancies, early diagnosis and treatment are essential to reducing maternal mortality. In addition, after termination of such pregnancies, examination of the patients for early detection of trophoblastic tumors is very important.</span></span><br> &nbsp; حاملگی دو قلویی, مولار Twin pregnancy, Molar pregnancy 117 123 http://sjku.muk.ac.ir/browse.php?a_code=A-10-1318-5&slc_lang=fa&sid=1 shamsi zare شمسی زارع shamsi.zare66@gmail.com 5400319475328460056456 5400319475328460056456 No Assistant Professor, Department of Obstetrics and Gynecology,Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran استادیار، گروه زنان و زایمان ، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران nasrin sufizadeh نسرین صوفی زاده paimanrezagholy@yahoo.com 5400319475328460056457 5400319475328460056457 No Assistant Professor, Department of Obstetrics and Gynecology,Faculty of Medicine,Behsat Hospital ,Kurdistan University of Medical Sciences, 98, Iran استادیار، گروه زنان و زایمان، دانشکده پزشکی ، دانشگاه علوم پزشکی کردستان، سنندج، ایران sara mohammadi سارا محمدی smohamadi91070@gmail.com 5400319475328460056458 5400319475328460056458 No Instructor, Department of Operating Room, School of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran. مربی،گروه تکنولوژی اتاق عمل، دانشکده پیراپزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران. payman rezagholi پیمان رضاقلی paimanrezagholy@gmail.com 5400319475328460056459 5400319475328460056459 Yes Instructor,Department of Operating Room, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences,Sanandaj,Iran مربی،گروه اتاق عمل، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کردستان، سنندج، ایران