Batton D G, Amanullah A, Comstock C
Department of Pediatrics and Obstetrics, William Beaumont Hospital, Royal Oak, Michigan, USA.
J Pediatr Hematol Oncol. 2000 May-Jun;22(3):259-61. doi: 10.1097/00043426-200005000-00013.
A rare case of schistocytic hemolytic anemia presenting in a fetus secondary to a varix of the intra-abdominal umbilical vein is reported. A patient was referred to our hospital at 32 weeks of gestation because of an abnormal hypoechoic finding in the fetal liver. Prenatal ultrasound showed turbulent flow through a 12-mm diameter dilatation of the fetal intra-abdominal umbilical vein consistent with a varix. Cardiomegaly also was noted. At birth, the 1098-g, growth-retarded, male neonate was in severe congestive heart failure secondary to anemia as the initial hemoglobin was 5 g/dL. Additional evaluation found the anemia to be secondary to schistocytic hemolysis. After the neonate received a transfusion of packed erythrocytes and supportive care, the anemia quickly resolved, and he was discharged to home doing well after a 6-week stay in the neonatal intensive care unit. Prompt recognition of the varix prenatally and thorough evaluation of the newborn postnatally led to appropriate diagnosis and treatment.
报告了一例罕见的胎儿期因腹内脐静脉静脉曲张继发的裂体细胞性溶血性贫血病例。一名患者在妊娠32周时因胎儿肝脏出现异常低回声而被转诊至我院。产前超声显示胎儿腹内脐静脉直径12毫米的扩张处有湍流，符合静脉曲张表现。同时还发现有心脏扩大。出生时，这名体重1098克、发育迟缓的男婴因贫血继发严重充血性心力衰竭，初始血红蛋白为5克/分升。进一步评估发现贫血是由裂体细胞性溶血所致。新生儿接受浓缩红细胞输血及支持治疗后，贫血迅速缓解，在新生儿重症监护病房住院6周后顺利出院。产前对静脉曲张的及时识别及产后对新生儿的全面评估促成了恰当的诊断与治疗。
