Deering Shad H, Heller Jessica, Winkel Craig, Landy Helain J
Division of Maternal-Fetal Medicine, Georgetown University Hospital, Washington, DC 20007, USA.
Obstet Gynecol. 2003 Oct;102(4):693-5. doi: 10.1016/s0029-7844(03)00678-1.
Fetal head entrapment during delivery is a rare occurrence in modern obstetrics. We present a case of intrauterine head entrapment of a second twin by a uterine synechia diagnosed by ultrasound and subsequent complications that occurred.
A woman with a twin intrauterine pregnancy presented at 19 weeks for evaluation of a shortened cervix. Ultrasound examination demonstrated fetal head entrapment of twin B by a uterine synechia, as well as intrauterine growth restriction (IUGR). The patient experienced preterm premature rupture of membranes at 24 weeks' gestation and underwent a cesarean delivery for a nonreassuring fetal heart rate tracing of twin B, with findings of a constricting band of fibrous tissue around the neck of twin B.
Uterine synechia might cause intrauterine head entrapment and IUGR.
分娩时胎儿头部嵌顿在现代产科中较为罕见。我们报告一例经超声诊断为子宫粘连导致的第二胎宫内头部嵌顿及随后发生的并发症。
一名怀有双胎妊娠的女性在孕19周时因宫颈缩短前来评估。超声检查显示双胎B的头部被子宫粘连嵌顿，同时存在宫内生长受限（IUGR）。该患者在妊娠24周时发生胎膜早破，因双胎B的胎心监护结果不佳而接受剖宫产，术中发现双胎B颈部有一条纤维组织束带。
子宫粘连可能导致宫内头部嵌顿和宫内生长受限。
