Schröter B, Chaoui R, Meisel H, Bollmann R
Abteilung Pränatale Diagnostik und Therapie, Humboldt-Universität Berlin.
Z Geburtshilfe Neonatol. 1999 Jan-Feb;203(1):36-8.
A 16-year-old primigravida was referred to our department at 22 weeks gestation because of a nonimmune hydrops fetalis. Sonography revealed an isolated fetal ascites. Cordocentesis was performed to rule out anaemia, infection and chromosomale abnormalities, followed subsequently by intrauterine transfusion because of fetal anaemia (hemoglobin-concentration of 8.4 g/dl). It was found that the pregnant suffered from an acute hepatitis-B-virus-infection with positive HBsAg, positive HBeAg and HBc-IgM antibodies, confirmed by serological tests. In a second cordocentesis the cordblood specimen was found to be HBsAg positive as well. The fetus was intramusculary given hyperimmune-globulin under ultrasound guidance. In the further course of pregnancy signs of meconium-peritonitis were observed. Postnatally a distal ileal perforation was detected and the newborn underwent laparotomy for distal ileal perforation. In this case report we discuss the connection with nonimmune hydrops fetalis and the maternal and fetal hepatitis-B-virus-infection.
一名16岁初产妇在妊娠22周时因胎儿非免疫性水肿被转诊至我院。超声检查发现单纯性胎儿腹水。进行脐血穿刺以排除贫血、感染和染色体异常，随后因胎儿贫血（血红蛋白浓度为8.4 g/dl）进行宫内输血。血清学检查证实该孕妇患有急性乙型肝炎病毒感染，HBsAg、HBeAg呈阳性，HBc-IgM抗体阳性。在第二次脐血穿刺中，发现脐血标本HBsAg也呈阳性。在超声引导下给胎儿肌肉注射高效价免疫球蛋白。在妊娠后期观察到胎粪性腹膜炎的体征。出生后检测到回肠远端穿孔，新生儿因回肠远端穿孔接受了剖腹手术。在本病例报告中，我们讨论了与胎儿非免疫性水肿以及母婴乙型肝炎病毒感染的关联。
