Anandakumar C, Wong Y C, Biswas A, Venkat A, Chia D, Arulkumaran S, Ratnam S S
Department of Obstetrics and Gynaecology, National University Hospital, Singapore.
Asia Oceania J Obstet Gynaecol. 1992 Dec;18(4):319-23. doi: 10.1111/j.1447-0756.1992.tb00326.x.
Vesico-rectal fistula is a rare congenital abnormality causing severe early second trimester oligohydramnios. Prenatal diagnosis of such a case is reported here. Ultrasound diagnosis could be aided by transabdominal amnio-infusion and, if necessary, fetal intraperitoneal saline installation. In a karyotypically normal fetus with normal somatic growth, demonstration of normal fetal kidneys together with a functioning urinary bladder, in presence of severe oligohydramnios, is very suggestive of the diagnosis. Since pulmonary hypoplasia is the major cause of neonatal mortality in these cases, restoration of normal amniotic fluid volume by serial amnio-infusion was attempted. Although amnio-infusion is an important diagnostic aid in the evaluation of severe midtrimester oligohydramnios, the role of multiple therapeutic amnio-infusion in improving lung growth remains to be evaluated.
膀胱直肠瘘是一种罕见的先天性异常，可导致孕中期严重羊水过少。本文报道了此类病例的产前诊断。经腹羊膜腔灌注有助于超声诊断，必要时可向胎儿腹腔内注入生理盐水。对于染色体核型正常且躯体生长正常的胎儿，在严重羊水过少的情况下，若显示胎儿肾脏正常且膀胱功能正常，则强烈提示该诊断。由于肺发育不全是这些病例新生儿死亡的主要原因，因此尝试通过连续羊膜腔灌注恢复正常羊水量。虽然羊膜腔灌注在评估孕中期严重羊水过少时是一种重要的诊断辅助手段，但多次治疗性羊膜腔灌注对促进肺生长的作用仍有待评估。
