Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
Ultrasound Obstet Gynecol. 2009 Apr;33(4):484-6. doi: 10.1002/uog.6348.
Amniotic fluid 'sludge' is defined as the presence of dense aggregates of particulate matter in close proximity to the internal cervical os. It is of clinical significance in asymptomatic patients at high risk for spontaneous delivery, and in patients with preterm labor and intact membranes. Subchorionic hematoma is another ultrasound finding that is associated with a higher incidence of threatened miscarriage and preterm delivery. We report two cases of occurrence of amniotic fluid sludge in patients with previously detected large subchorionic hematoma. In the first case subchorionic hematoma and amniotic fluid sludge were detected by ultrasonography at 13 + 1 and 18 + 6 weeks' gestation, respectively, followed by preterm premature rupture of membranes, placental abruption and emergency Cesarean section. In the second case subchorionic hematoma and amniotic fluid sludge were detected by ultrasound at 11 + 3 and 15 + 5 weeks' gestation, respectively, followed by miscarriage with histological chorioamnionitis. The coincidence of subchorionic hematoma and amniotic fluid sludge in these cases points to a possible connection between these two significant ultrasound findings.
羊水“胎粪”定义为在靠近宫颈内口的位置存在密集的颗粒状物质聚集。在有自发性分娩高风险的无症状患者以及有早产和胎膜完整的患者中，具有临床意义。胎盘下血肿是另一种与较高的难免流产和早产发生率相关的超声发现。我们报告了两例先前发现的大胎盘下血肿患者出现羊水胎粪的病例。在第一个病例中，分别在妊娠 13+1 周和 18+6 周时通过超声检查发现胎盘下血肿和羊水胎粪，随后出现胎膜早破、胎盘早剥和急诊剖宫产。在第二个病例中，分别在妊娠 11+3 周和 15+5 周时通过超声检查发现胎盘下血肿和羊水胎粪，随后发生难免流产并伴有组织学绒毛膜炎。这些病例中胎盘下血肿和羊水胎粪的同时出现表明这两种重要的超声发现之间可能存在关联。
