Suzumori Nobuhiro, Hattori Yukio, Kaneko Saori, Suzuki Yoshikatsu, Sugiura-Ogasawara Mayumi
Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
Congenit Anom (Kyoto). 2009 Dec;49(4):274-5. doi: 10.1111/j.1741-4520.2009.00242.x.
A 22-year-old pregnant woman noticed a rapid increase of abdominal growth, uterine tenderness and irregular contraction, for which she hospitalized at 25 weeks of gestation. An ultrasound examination demonstrated a single fetus with normal anatomy and massive hydramnios. Serial therapeutic amniocentesis was performed for relief of maternal symptoms and indomethacin compress was initiated. Both the maternal and amniotic fluid IgM were positive for cytomegalovirus (CMV). Maternal compress indomethacin was discontinued at 32 weeks. Cesarean section was performed due to fetal distress at 34 weeks of gestation. A female infant was delivered and the neonatal examination was within normal limits with urine culture positive for CMV. At 1 year of age the child was developing normally with normal hearing and no clinical sequelae of intrauterine CMV infection. We postulate that serial and large volume reduction of amniotic fluid by amniocentesis and compress indomethacin in our case interrupted the natural course and provided sufficient time for the fetus to recover from the acute phase of viral infection.
一名22岁的孕妇注意到腹部迅速增大、子宫压痛和不规则宫缩，于妊娠25周时住院。超声检查显示单胎，解剖结构正常，但有大量羊水过多。为缓解母体症状，进行了系列治疗性羊膜腔穿刺术，并开始使用吲哚美辛外敷。母体和羊水的IgM均为巨细胞病毒（CMV）阳性。母体吲哚美辛外敷于32周时停用。因胎儿窘迫，于妊娠34周行剖宫产。娩出一名女婴，新生儿检查正常，但尿培养CMV阳性。1岁时，该儿童发育正常，听力正常，无宫内CMV感染的临床后遗症。我们推测，在我们的病例中，通过羊膜腔穿刺术系列大量减少羊水和吲哚美辛外敷中断了自然病程，为胎儿从病毒感染急性期恢复提供了足够的时间。
