Sugai Kazuko, Ito Michiru, Tateishi Itaru, Funabiki Tetsunori, Nishikawa Masanori
Department of Pediatrics, Fujisawa City Hospital, Kanagawa, Japan.
Allergol Int. 2006 Jun;55(2):207-12. doi: 10.2332/allergolint.55.207.
We report a neonatal case of cystic periventricular leukomalacia (PVL) in which the hypoxia was considered to have been caused by severe asthma in the mother, who had not taken any medication during pregnancy because she was anxious about its possible effects on her unborn child.
After the mother had severe exacerbation of asthma for five days, the baby was born at 36 weeks in gestation, weighing 2100 g, and with moderate asphyxia. Although the baby had been aggressively treated in a neonatal intensive care unit, at birth, an ischemic area had been formed in the periventricular areas in the brain echogram. We suspected that she had severe brain damage due to prenatal hypoxia.
The baby was found to have cystic PVL by ultrasonography at age 15 days, and diplegia at age 4 months.
The poorly controlled, persistent and severe asthma of the mother may have caused prenatal hypoxia, resulting in the cystic PVL and lower limb palsy. Pregnant patients with poorly controlled asthma should be advised of the great risk of this condition to the fetus. Also, patients should be assured of the safety of modern asthma treatments.
我们报告一例新生儿脑室周围白质软化症（PVL）病例，其缺氧被认为是由母亲的重度哮喘所致，该母亲在孕期因担心药物可能对未出生胎儿产生影响而未服用任何药物。
母亲哮喘严重加重五天后，婴儿于孕36周出生，体重2100克，有中度窒息。尽管婴儿在新生儿重症监护病房接受了积极治疗，但出生时脑部超声检查显示脑室周围区域已形成缺血区。我们怀疑她因产前缺氧而有严重脑损伤。
婴儿在15日龄时经超声检查发现患有囊性PVL，4月龄时出现双瘫。
母亲控制不佳、持续且严重的哮喘可能导致产前缺氧，进而导致囊性PVL和下肢麻痹。应告知哮喘控制不佳的孕妇胎儿发生这种情况的巨大风险。此外，应向患者保证现代哮喘治疗的安全性。
