Shimizu Shoko, Kawagishi Rikako, Arimoto-Ishida Emi, Wada Kazuko, Shimoya Koichiro, Murata Yuji
Department of Obstetrics and Gynecology, Faculty of Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
J Obstet Gynaecol Res. 2003 Oct;29(5):312-6. doi: 10.1046/j.1341-8076.2003.00121.x.
We encountered two cases of severe intrauterine hemorrhage associated with congenital intestinal atresia. In both cases, the first sign that necessitated immediate clinical management was the abnormal fetal heart rate patterns, represented by prolonged bradycardias and late decelerations. This occurred immediately after the onset of labor. An emergency cesarean section was performed on both patients and, despite being born with severe anemia, the condition of the infants was excellent. We found that continuous fetal heart rate monitoring should be performed if polyhydramniosis suspected, when the fetus is diagnosed with congenital intestinal atresia and when changes in intrauterine pressure are clinically expected, such as at the onset of labor or after amniocentesis.
我们遇到了两例与先天性肠闭锁相关的严重子宫内出血病例。在这两例中，需要立即进行临床处理的首个迹象是异常的胎儿心率模式，表现为长时间心动过缓和晚期减速。这在分娩开始后立即出现。对两名患者均实施了紧急剖宫产术，尽管婴儿出生时患有严重贫血，但状况良好。我们发现，如果怀疑羊水过多、胎儿被诊断为先天性肠闭锁以及临床上预期子宫内压力会发生变化时，例如在分娩开始时或羊膜穿刺术后，应进行持续的胎儿心率监测。
