羊膜带综合征1例

L. Qu, T. Yin, Yang Wu
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摘要

本文报告了一例羊膜带综合征(ABS)。在妊娠22+4周时,系统超声检查未发现明显的胎儿异常。妊娠30周时,根据超声图像发现孕妇羊水过多,可能有胎儿水肿,住进了南京医科大学附属第一医院。入院后,她接受了饮食控制,以降低血糖和羊水减少。通过超声测量动态羊水指数,并每天监测电胎心率。自妊娠32周以来,观察到胎儿运动逐渐减少,胎儿心率呈正弦曲线。在孕龄32+3周时,由于胎儿窘迫进行了紧急剖宫产。手术中,从胎盘的脐带插入到胎儿左下肢的脚踝,发现了一层多孔的羊膜。新生儿左足踝羊膜带狭窄,左脚水肿明显,诊断为ABS。这个羊膜带直接影响胎儿的左脚,而胎盘脐带插入处附近的片状羊膜是否会影响胎儿,目前还没有足够的证据。这名早产婴儿在出生24小时后死于新生儿窒息。关键词:羊膜带综合征;产前超声检查;异常,多个
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Amniotic band syndrome: a case report
A case of amniotic band syndrome (ABS) was reported here. No obvious fetal abnormality was revealed by systematic ultrasound at 22+4 weeks of gestation. At 30 weeks of gestation, the pregnant woman was found to have excessive amniotic fluid and possible fetal edema according to ultrasound images and admitted to the First Affiliated Hospital of Nanjing Medical University. After admission, she received diet control to lower blood glucose and amniotic fluid reduction. The dynamic amniotic fluid index was measured by ultrasound, and the electrical fetal heart rate was monitored daily. Since 32 weeks of gestation, progressive reduction in fetal movement with sinusoidal fetal heart rate pattern was observed. An emergent cesarean section was performed due to fetal distress at a gestational age of 32+3 weeks. During the operation, a porous amniotic membrane was found, from the umbilical cord insertion of the placenta to the ankle of the left lower limb of the fetus. Amniotic band constricting left ankle of newborn and the edema of the left foot was obvious, then ABS was diagnosed. This amniotic band affected the left foot of the fetus directly, while there was not enough evidence whether the flake amniotic membrane near the umbilical cord insertion of the placenta could affect the fetus. This premature infant died of neonatal asphyxia 24 hours after birth. Key words: Amniotic band syndrome; Ultrasonography, prenatal; Abnormalities, multiple
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中华围产医学杂志
中华围产医学杂志 Medicine-Obstetrics and Gynecology
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4446
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