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Treacher Collins syndrome – a case report Treacher Collins综合征1例报告
IF 0.1 Pub Date : 2022-09-20 DOI: 10.1515/crpm-2020-0009
Magda Fraszczyk-Tousty, A. Jankowska, J. Tousty, Piotr Tousty, B. Łoniewska
Abstract Objectives Treacher Collins syndrome (TCS), also known as mandibulofacial dysostosis and Franceschetti-Zwahlen- Klein syndrome, is an autosomal dominant disorder of soft tissue and the craniofacial bones. In most cases, TCS is the result of a mutation in the TCOF1 gene. The incidence is estimated to be between 1/10,000 and 1/50,000 live births. Our purpose was to describe a case report of patient with TCS born in the Department of Neonatology at the Pomeranian Medical University in Szczecin (Poland) and his family with short review of literature. Case presentation Clinical abnormalities which were found after birth mainly affect the head – hypoplasia of the cheek bones and the zygomatic bones, micrognation, deformed auricles with undeveloped external auditory canals, retrognathia of the mandible, cleft hard and soft palate and narrow palpebral fissure. Conclusions The treatment of children with TCS is long-term. Patients require a series of reconstructive and plastic surgical procedures. Our patient presented the complete form of TCS. There are multiple surgeries awaiting him, which, eventually, will improve his quality of life.
【摘要】目的Treacher Collins综合征(TCS),又称下颌面骨缺损、Franceschetti-Zwahlen- Klein综合征,是一种常染色体显性遗传病,主要发生于软组织和颅面骨。在大多数情况下,TCS是TCOF1基因突变的结果。据估计,发病率在1/10,000至1/50,000活产之间。我们的目的是描述一例在什切青(波兰)波美拉尼亚医科大学新生儿科出生的TCS患者及其家庭,并对文献进行简短的回顾。出生后出现的临床异常主要表现为头部发育不全,颧骨、颧骨发育不全,耳廓畸形,外耳道发育不全,下颌骨后突,软硬腭裂,睑裂狭窄。结论小儿TCS的治疗是长期的。患者需要进行一系列的重建和整形外科手术。我们的病人呈现完整的TCS形式。等待他的是多次手术,这些手术最终将改善他的生活质量。
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引用次数: 0
A case of placental multiple giant chorangioma leading to neonatal death from fetal hydrops 胎儿积水致胎盘多发性巨大脉管瘤新生儿死亡1例
IF 0.1 Pub Date : 2022-09-12 DOI: 10.1515/crpm-2022-0008
Aoi Shiraga, Takuma Ohsuga, K. Kawasaki, Haruta Mogami, S. Minamiguchi, Masaki Mandai
Abstract Objectives Although placental chorangiomas are often asymptomatic, larger tumors (>4–5 cm) can cause various perinatal complications, including polyhydramnios, preterm birth, fetal anemia, fetal hydrops, and intrauterine fetal death. Symptomatic placental chorangiomas are often diagnosed prenatally on ultrasonography as a mass on the fetal side of the placenta. Case presentation A 37-year-old pregnant woman underwent emergency cesarean delivery at 34 weeks’ gestation due to rapidly progressive fetal hydrops leading to fetal dysfunction, resulting in neonatal death. Placental pathology indicated multiple placental giant chorangiomas that occupied 40% of the placenta. Because of the disk shape of the placenta, prenatal diagnosis by ultrasonography was difficult. Conclusions Some placental chorangiomas are difficult to diagnose and lead to fetal hydrops and poor prognosis, even if ultrasonography does not show an obvious mass in the placenta.
目的虽然胎盘绒毛膜瘤通常无症状,但较大的肿瘤(> 4-5 cm)可引起各种围产期并发症,包括羊水过多、早产、胎儿贫血、胎儿水肿和宫内胎儿死亡。有症状的胎盘绒毛膜瘤通常在产前超声检查中被诊断为胎盘胎儿侧的肿块。一例37岁孕妇在妊娠34周时因迅速进展的胎儿水肿导致胎儿功能障碍,导致新生儿死亡,接受紧急剖宫产。胎盘病理显示多发性巨大绒毛膜瘤占胎盘的40%。由于胎盘呈盘状,产前超声诊断比较困难。结论部分胎盘绒毛膜瘤即使超声检查未见明显肿块,诊断困难,可导致胎儿水肿,预后差。
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引用次数: 1
Embolization of uterine artery pseudoaneurysm during pregnancy: case report and review of the literature 妊娠期子宫动脉假性动脉瘤栓塞:病例报告及文献复习
IF 0.1 Pub Date : 2022-09-07 DOI: 10.1515/crpm-2022-0010
C. Metz, L. Hinkson, B. Gebauer, W. Henrich
Abstract Objectives Uterine artery pseudoaneurysm (UAP) is a rare but sinister complication during pregnancy. Diagnosis can be made by color Doppler ultrasound. Previous abdominal- and obstetric surgery increase the risk for UAP formation. Case presentation We present a case of a 36 year young healthy women, presenting at 27 weeks of gestation with acute lower abdominal pain. UAP was detected by color Doppler ultrasound. An endovascular coil embolization was performed, with good maternal and fetal outcome. Furthermore, a review of the literature looking at UAP embolization in pregnancy was performed. Conclusions UAP is reported to appear as a complication of endometriosis. UAP should be treated by endovascular coil embolization, which is a safe and with almost 100% success rate an effective treatment during pregnancy.
摘要目的子宫动脉假性动脉瘤(UAP)是一种罕见但危险的妊娠并发症。可用彩色多普勒超声诊断。以前的腹部和产科手术增加了UAP形成的风险。我们提出一个病例36岁的年轻健康妇女,在妊娠27周出现急性下腹痛。彩色多普勒超声检测UAP。行血管内线圈栓塞术,母婴预后良好。此外,回顾了妊娠期UAP栓塞的文献。结论UAP是子宫内膜异位症的一种并发症。妊娠期UAP应采用血管内线圈栓塞治疗,这是一种安全且成功率接近100%的有效治疗方法。
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引用次数: 1
Pregnancy associated atypical hemolytic uremic syndrome presenting with preeclampsia with HELLP syndrome and following treatment with Eculizumab 妊娠相关的非典型溶血性尿毒症综合征表现为伴有HELLP综合征的先兆子痫,随后用Eculizumab治疗
IF 0.1 Pub Date : 2022-09-02 DOI: 10.1515/crpm-2022-0016
F. Gunawan, M. Mangler, C. Sanders, Trisha Ardine Leonardo, Y. Cindy
Abstract Objectives Pregnancy associated atypical hemolytic uremic syndrome (p-aHUS) is a rare condition of thrombotic microangiopathy (TMA) which causes an increase of fetal and maternal morbidity and mortality. It presents typically with a triad of microangiopathic hemolytic anemia (MAHA), thrombocytopenia and acute progressive renal failure. Differential diagnoses of HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelets) syndrome, preeclampsia, thrombotic thrombocytopenic purpura (TTP), and disseminated intravascular coagulation (DIC) syndrome must be considered. In the following case report, presented is a 32-year-old, 38 weeks pregnant Caucasian woman admitted to Eberswalde Hospital with signs of preeclampsia and HELLP Syndrome. Caesarean Section was performed due to HELLP syndrome and fetal distress. Acute renal failure occurs shortly after a successful delivery. After a diagnosis of p-aHUS is established, the patient was given Eculizumab, which yielded significant improvements. Case presentation A 32-year-old, 38 week pregnant Caucasian woman was admitted to Eberswalde Hospital with upper right abdominal pain. After a laboratory examination, a diagnosis of HELLP syndrome was established and a Caesarean Section was performed. The follow-up examination revealed deterioration of clinical signs with the patient experiencing dyspnea, oliguria, and oedema, as well as aggravation of laboratory values, ranging from severe thrombocytopenia, hemolytic anemia, liver injury, and acute kidney injury. After excluding other possible causes of TMA, a diagnosis of p-aHUS was established and a treatment with Eculizumab was administered. Clinical and laboratory signs of hemolysis and kidney functions were found to improve gradually after two administrations of Eculizumab. The patient was discharged after 20 days of hospitalization with significantly improved condition and hematological values. Conclusions A successful treatment of p-aHUS requires a comprehensive assessment and a prompt diagnosis, which can be confounded by multiple similar differential diagnoses. Treatment with Eculizumab was found to significantly improve the outcome of the patient, but more studies are required to decide on a standardized regiment for p-aHUS.
摘要目的妊娠相关非典型溶血性尿毒症综合征(p-aHUS)是一种罕见的血栓性微血管病(TMA),导致胎儿和孕产妇发病率和死亡率增加。它通常表现为微血管病溶血性贫血(MAHA)、血小板减少症和急性进行性肾功能衰竭。必须考虑HELLP(溶血、肝酶升高和血小板减少)综合征、先兆子痫、血栓性血小板减少性紫癜(TTP)和弥散性血管内凝血(DIC)综合征的鉴别诊断。在以下病例报告中,提出了一名32岁,怀孕38周的白人妇女,因先兆子痫和HELLP综合征的症状住进Eberswalde医院。因HELLP综合征及胎儿窘迫行剖宫产。急性肾衰竭发生在成功分娩后不久。在确定p-aHUS诊断后,给予患者Eculizumab治疗,效果显著改善。病例介绍一名32岁,怀孕38周的白人妇女因右上腹部疼痛住进Eberswalde医院。经过实验室检查,诊断为HELLP综合征,并进行了剖腹产手术。随访检查发现临床症状恶化,患者出现呼吸困难、少尿、水肿,实验室指标加重,包括严重血小板减少、溶血性贫血、肝损伤和急性肾损伤。在排除其他可能的TMA原因后,诊断为p-aHUS,并给予Eculizumab治疗。临床和实验室迹象发现溶血和肾功能逐渐改善后,两次给药Eculizumab。患者住院20天后出院,病情和血液学指标明显改善。结论p-aHUS的成功治疗需要全面的评估和及时的诊断,这可能被多个相似的鉴别诊断所混淆。使用Eculizumab治疗可显著改善患者的预后,但需要更多的研究来确定p-aHUS的标准化治疗方案。
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引用次数: 1
Cholestasis and congenital neuroblastoma in a preterm neonate: a case report 早产新生儿胆汁淤积和先天性神经母细胞瘤1例报告
IF 0.1 Pub Date : 2022-09-02 DOI: 10.1515/crpm-2021-0089
S. Puvabanditsin, Melissa Guillermo, Yi-Chou Cheng, Olga Sudol, R. Mehta
Abstract Objectives Neuroblastoma (NB) is one of the most common tumor during perinatal period. The clinical features of NB occurring in fetuses and neonates differ from that in the older age groups. Frequently, Congenital neuroblastomas are incidentally detected prenatally. Clinical presentations of NBs in neonates are highy variable. Case presentation A 24-day old preterm 32 weeks’ gestation male neonate developed cholestasis that lead to the diagnosis of stage MS neuroblastoma. There was no NB primary site identified. Conclusions To the best of our knowledge, this is the first case report of metastatic NB (Stage MS) in a preterm neonate presenting with cholestsis but without any identifiable adrenal or extra-adrenal primary.
摘要目的神经母细胞瘤(Neuroblastoma, NB)是围产期最常见的肿瘤之一。新生儿新生儿NB的临床特征与老年人群不同。通常,先天性神经母细胞瘤是在产前偶然发现的。新生儿NBs的临床表现变化很大。一例早产24天、孕32周的男婴出现胆汁淤积,诊断为MS期神经母细胞瘤。未发现NB主站点。结论:据我们所知,这是第一例转移性NB (MS期)在早产新生儿中表现为胆汁症,但没有任何可识别的肾上腺或肾上腺外原发灶。
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引用次数: 0
Gitelman syndrome diagnosed in the first trimester of pregnancy: a case report and literature review 妊娠早期诊断的吉特尔曼综合征:1例报告及文献回顾
IF 0.1 Pub Date : 2022-09-02 DOI: 10.1515/crpm-2021-0075
Yang Cao, Dandan Hu, Peng Yun, Xinwei Huang, Yan Chen, Fangping Li
Abstract Objectives Gitelman syndrome is a rare salt-losing tubulopathy caused by inactivating mutations in the SLC12A3 gene, which is expressed in the distal convoluted tubule and accounts for 5–10% of renal sodium reabsorption. Atypical symptoms and insidious conditions generally delay diagnosis until childhood or even adulthood. Here, we report the case of a 22-year-old Chinese woman who was admitted to our endocrinology department for severe hypokalemia during pregnancy. Case presentation The patient had no specific symptoms but exhibited hypokalemia, metabolic alkalosis, hypomagnesemia, hypocalciuria, hyperreninemia, hyperaldosteronism, and normal blood pressure. Together, these symptoms indicated the clinical diagnosis of Gitelman syndrome, which was confirmed by genetic analysis. Many drugs have limited safety data during early pregnancy, and optimum potassium and magnesium levels are necessary for a successful pregnancy. Conclusions Diagnosis and management of Gitelman syndrome are crucial during pregnancy to ensure the safety of the mother and fetus, especially during the first trimester.
【摘要】目的Gitelman综合征是一种罕见的由SLC12A3基因失活突变引起的失盐小管病,该基因表达于远曲小管,占肾脏钠重吸收的5-10%。非典型症状和潜伏的条件通常延迟诊断,直到儿童甚至成年。在这里,我们报告一例22岁的中国妇女,她在怀孕期间因严重的低钾血症而入院内分泌科。患者无特殊症状,但表现为低钾血症、代谢性碱中毒、低镁血症、低钙尿症、高肾素血症、高醛固酮血症和血压正常。总之,这些症状表明Gitelman综合征的临床诊断,这是由遗传分析证实。许多药物在妊娠早期的安全性数据有限,而最佳的钾和镁水平是成功妊娠所必需的。结论妊娠期,尤其是妊娠早期,对Gitelman综合征的诊断和处理是保证母胎安全的关键。
{"title":"Gitelman syndrome diagnosed in the first trimester of pregnancy: a case report and literature review","authors":"Yang Cao, Dandan Hu, Peng Yun, Xinwei Huang, Yan Chen, Fangping Li","doi":"10.1515/crpm-2021-0075","DOIUrl":"https://doi.org/10.1515/crpm-2021-0075","url":null,"abstract":"Abstract Objectives Gitelman syndrome is a rare salt-losing tubulopathy caused by inactivating mutations in the SLC12A3 gene, which is expressed in the distal convoluted tubule and accounts for 5–10% of renal sodium reabsorption. Atypical symptoms and insidious conditions generally delay diagnosis until childhood or even adulthood. Here, we report the case of a 22-year-old Chinese woman who was admitted to our endocrinology department for severe hypokalemia during pregnancy. Case presentation The patient had no specific symptoms but exhibited hypokalemia, metabolic alkalosis, hypomagnesemia, hypocalciuria, hyperreninemia, hyperaldosteronism, and normal blood pressure. Together, these symptoms indicated the clinical diagnosis of Gitelman syndrome, which was confirmed by genetic analysis. Many drugs have limited safety data during early pregnancy, and optimum potassium and magnesium levels are necessary for a successful pregnancy. Conclusions Diagnosis and management of Gitelman syndrome are crucial during pregnancy to ensure the safety of the mother and fetus, especially during the first trimester.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83521144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multimodal postpartum imaging of a severe case of Couvelaire uterus. 重症库夫莱尔子宫的多模式产后显像分析。
IF 0.1 Pub Date : 2022-06-07 eCollection Date: 2022-01-01 DOI: 10.1515/crpm-2021-0013
Josef Jackson, Verghese George, Jennifer McKinney, Karin A Fox

Objectives: Placental abruption occurs when a normally implanted placenta prematurely separates, causing rupture of decidual spiral arteries and retroplacental hemorrhage. Estimates place the incidence of placental abruption somewhere between 0.22% and 1% of all deliveries. Clinical abruption represents a spectrum from mild to the most severe form, in which blood can extravasate into or through the myometrium, the broad ligament, or the peritoneum, causing the uterus and surrounding structures to take on a blue discoloration. This phenomenon is a clinical entity known as Couvelaire uterus, so named because it was first described by French physician Alexandre Couvelaire in the early 20th century as "uteroplacental apoplexy." Its incidence is difficult to estimate because it has classically been diagnosed only by direct intraoperative visualization. Imaging is not usually indicated in this clinical setting, so radiologic correlation with operative findings has not been previously described.

Case presentation: In this report, we discuss the case of a multipara who presented with abdominal pain and vaginal discharge several days after a classical cesarean delivery. Her prolonged and complex clinical course led to evaluation via several radiologic modalities. At first, a focal placenta accreta or retained products of conception were suspected, however these diagnoses did not correlate with the patient's reported intraoperative findings of a clean endometrial cavity or with histopathology that was consistent with massive abruption.

Conclusions: The clinical presentation and features identified on multimodal imaging were ultimately most consistent with the patient's intraoperative diagnosis of Couvelaire uterus.

目的:胎盘早剥发生在正常植入的胎盘过早分离时,引起蜕膜螺旋动脉破裂和胎盘后出血。估计胎盘早剥的发生率在所有分娩的0.22%到1%之间。临床早剥表现为从轻度到最严重的形式,在这种情况下,血液可以渗进或通过肌层、阔韧带或腹膜,导致子宫和周围结构呈现蓝色。这种现象在临床上被称为库夫莱尔子宫,之所以如此命名,是因为法国医生亚历山大·库夫莱尔(Alexandre Couvelaire)在20世纪初首次将其描述为“子宫胎盘中风”。它的发生率很难估计,因为它通常只能通过直接术中观察来诊断。在这种临床情况下,通常不需要影像学检查,因此放射学与手术结果的相关性以前没有描述过。病例介绍:在本报告中,我们讨论了一例多产妇,在经典剖宫产后几天出现腹痛和阴道分泌物。她漫长而复杂的临床过程导致通过几种放射方式进行评估。起初,怀疑是局灶性胎盘增生或妊娠产物残留,但这些诊断与患者报告的术中子宫内膜腔清洁或组织病理学一致的大量早剥并不相关。结论:多模态影像所识别的临床表现和特征最终与患者术中对库韦莱尔子宫的诊断最为一致。
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引用次数: 1
Fetal intracranial hemorrhage in a case of 16p microdeletion 16p微缺失1例胎儿颅内出血
IF 0.1 Pub Date : 2022-01-01 DOI: 10.1515/crpm-2021-0064
Margarita Álvarez-de-la-Rosa Rodríguez, Mercedes Hernández-Suárez, A. Padilla-Pérez, Ylenia Dévora-Cabrera, Walter Plasencia Acevedo
Abstract Objectives Intracranial hemorrhages are common events in premature infants but in fetal life those incidents are often of ominous prognosis and unknown etiology. Case presentation We present the diagnosis, evolution and management of a fetal hemorrhagic accident associated with an inherited maternal microdeletion of the chromosome 16 short arm. Abnormal neurosonography in routine second trimester ultrasound led to follow up. Fetal germinal matrix hemorrhage along with severe asymmetric ventriculomegaly and a secondary periventricular cyst developed in the early third trimester. Array CGH showed microdeletion 16p11.2. Conclusions This microdeletion had not been previously associated with fetal intracranial hemorrhage.
摘要目的颅内出血是早产儿的常见病,但在胎儿期往往预后不良,病因不明。我们提出的诊断,演变和管理胎儿出血事故与遗传母体微缺失的16号染色体短臂。妊娠中期常规超声异常导致随访。胎儿胚性基质出血伴严重不对称脑室肿大及继发性脑室周围囊肿发生于妊娠晚期。阵列CGH显示16p11.2微缺失。结论该微缺失先前未与胎儿颅内出血相关。
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引用次数: 0
Anaplastic ganglioglioma in pregnancy a cause of cerebral edema and maternal death 妊娠期间变性神经节胶质瘤是脑水肿和产妇死亡的原因之一
IF 0.1 Pub Date : 2022-01-01 DOI: 10.1515/crpm-2022-0002
L. F. Capera, Rafael L. Aragón Mendoza, Roberto Gallo Roa, Viviana Dávila Romero
Abstract Objectives The true incidence of anaplastic ganglioglioma during pregnancy is extremely rare, very few cases have been reported in the literature. Case presentation This is a report of a case of anaplastic ganglioglioma diagnosed in pregnancy. The patient is a 23-year-old primigravida who presented at 19 weeks of gestation headache and a convulsive episode. Her workup revealed a rare cerebral tumor that progressed to a neurological decline and died during the postpartum period. Conclusions Anaplastic ganglioglioma is an aggressive counterpart of Glial tumors; in pregnancy they are rare and symptoms are nonspecific. The outcome for the mother in this case fatal and a protocol for these cases has not yet been reported.
摘要目的间变性神经节胶质瘤在妊娠期的真实发病率极为罕见,文献报道的病例很少。本报告报告一例妊娠期诊断为间变性神经节胶质瘤。患者为23岁初产妇,妊娠19周时出现头痛和惊厥发作。她的检查发现了一种罕见的脑肿瘤,并发展为神经功能衰退,并在产后死亡。结论间变性神经节胶质瘤是一种侵袭性的神经胶质肿瘤;在怀孕期间,它们是罕见的,症状是非特异性的。在这个病例中,母亲的结局是致命的,目前还没有报告针对这些病例的方案。
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引用次数: 0
Umbilical artery aneurysm without aneuploidy and delivery of a live neonate 无非整倍体的脐动脉瘤和新生儿的活产
IF 0.1 Pub Date : 2022-01-01 DOI: 10.1515/crpm-2021-0091
G. Lewis, J. Dawkins, Xiangna Tang
Abstract Objectives Umbilical artery aneurysm, a rare structural anomaly of the umbilical cord, is frequently associated with fetal aneuploidy, fetal growth restriction and fetal demise. At present there are no definitive protocols or guidelines for the surveillance and management of this condition. Case presentation The index case is an 18-year-old primigravida who had an ultrasound at 35 weeks and 5 days gestation due to lagging symphysio-fundal height measurement. The ultrasound scan revealed a normal fetus with estimated fetal weight that was appropriate for gestational age. There was a cystic structure with internal echoes originating from the placenta at the point of the umbilical cord insertion, which was determined to be a 1.9 × 1.8 cm umbilical artery aneurysm on 3D and Doppler imaging. On follow up imaging the aneurysm had increased in size and measured 3.06 × 1.79 cm. The patient subsequently had a cesarean section delivery of a live female. Karyotyping subsequently revealed 46 XX. Conclusions A total of 15 cases of umbilical artery aneurysm have been reported in the literature to date, of which there were 5 live born infants with normal karyotype. The remaining 10 cases were intra-uterine fetal demise or trisomy 18 with subsequent neonatal deaths. When monitoring the aneurysms with ultrasound, change in size and Doppler indices play a pivotal role in helping to determine time and mode of delivery and thus allow for a favorable perinatal outcome.
摘要目的脐动脉动脉瘤是一种罕见的脐带结构异常,通常与胎儿非整倍体、胎儿生长受限和胎儿死亡有关。目前还没有明确的方案或指导方针来监测和管理这种情况。病例介绍:本病例为18岁的初孕女性,妊娠35周5天因联合生理-子宫高度测量滞后接受超声检查。超声扫描显示胎儿正常,估计胎儿体重与胎龄相符。在脐带插入处可见囊性结构,内部回声来自胎盘,三维及多普勒成像确定为1.9 × 1.8 cm脐动脉瘤。在随访影像中,动脉瘤增大,尺寸为3.06 × 1.79 cm。该患者随后接受了剖宫产术,产下一名活的女性。核型分析显示46 XX。结论文献报道脐动脉瘤共15例,其中5例出生婴儿核型正常。其余10例为子宫内胎儿死亡或18三体伴新生儿死亡。超声监测动脉瘤时,大小和多普勒指数的变化在帮助确定分娩时间和方式方面起着关键作用,从而有利于围产期预后。
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引用次数: 0
期刊
Case Reports in Perinatal Medicine
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