Ritter S, Jörn H, Ahaus M, Rath W
Frauenklinik für Gynäkologie und Geburtshilfe der Rheinisch-Westfälischen Technischen Hochschule Aachen, Abteilung Ultraschall und Pränataldiagnostik.
Z Geburtshilfe Neonatol. 2003 Jan-Feb;207(1):29-32. doi: 10.1055/s-2003-37842.
Infantile hepatic hemangioendothelioma is a benign hepatic tumor that can be associated with life-threatening perinatal complications. A 38-year-old gravida 3 para 2 was referred to our hospital with preterm labor at 33.6 gestational weeks. Fetal abdominal circumference was estimated sonographically above the 97 th percentile. Because of pathologic CTG, the fetus was delivered by caesarean section (APGAR-scores 0/0/7, pH: 7.15). After cardiopulmonary reanimation and intensive care of the fetus, the prenatally suspected hemangioma of the liver was confirmed by computer tomography. The day after, liver segments V, VI, and VII were resected because of lung compression. During the operation, reanimation was necessary two more times. Two days later, ductus arteriosus Botalli was occluded. After stabilization, the neonate was treated with prednisone because of tumor residues. If a large hyperechogenic mass in the fetal liver is seen prenatally, diagnosis of fetal hemangioma should be considered. In order to prevent serious cardiovascular complications, continual clinical surveillance is indicated.
婴儿肝血管内皮瘤是一种良性肝脏肿瘤,可伴有危及生命的围产期并发症。一名38岁、孕3产2的孕妇在妊娠33.6周时因早产被转诊至我院。超声检查估计胎儿腹围高于第97百分位数。由于病理性胎心监护图,胎儿通过剖宫产分娩(阿氏评分0/0/7,pH值:7.15)。在对胎儿进行心肺复苏和重症监护后,产前怀疑的肝脏血管瘤经计算机断层扫描得以确诊。次日,因肺部受压切除了肝段V、VI和VII。手术过程中,又进行了两次复苏。两天后,闭塞了动脉导管。病情稳定后,因肿瘤残留,新生儿接受了泼尼松治疗。如果产前在胎儿肝脏中发现一个大的高回声团块,应考虑胎儿血管瘤的诊断。为预防严重的心血管并发症,需要持续进行临床监测。