Nakajima Yoshiyuki, Masaoka Naoki, Tsuzuki Yoko, Morooka Masako, Sakai Masato
Department of Obstetrics and Gynecology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo-shi, Chiba, Japan.
J Obstet Gynaecol Res. 2012 Aug;38(8):1106-10. doi: 10.1111/j.1447-0756.2011.01840.x. Epub 2012 Apr 30.
Described is a 27-year-old pregnant woman with May-Thurner syndrome who experienced extensive pelvic and lower extremity thromboses during the antepartum period. The patient was referred for a symptomatic deep venous thrombosis at 23 weeks of gestation. Ultrasonography demonstrated a massive thrombus in the left iliofemoral vein. Heparin was given intravenously. Due to the possibility of pulmonary embolism during or immediately after delivery, a temporary inferior vena cava filter was inserted at 36 weeks of gestation. Labor was induced at 37 + 5 weeks of gestation; labor proceeded uneventfully and a male infant was born. Postpartum computed tomography (CT) demonstrated compression of the left common iliac vein by the right common iliac artery and lumbar vertebra. CT venogram demonstrated poor flow through the common iliac vein and well-developed collateral vessels. Critical stenosis at the origin of the left common iliac vein was consistent with a diagnosis of May-Thurner syndrome.
本文描述了一名27岁患有梅-图二氏综合征的孕妇，她在产前出现了广泛的盆腔和下肢血栓形成。该患者在妊娠23周时因症状性深静脉血栓形成而转诊。超声检查显示左髂股静脉有巨大血栓。给予静脉注射肝素。由于分娩期间或分娩后立即发生肺栓塞的可能性，在妊娠36周时插入了临时下腔静脉滤器。在妊娠37 + 5周时引产；分娩过程顺利，一名男婴出生。产后计算机断层扫描（CT）显示右髂总动脉和腰椎压迫左髂总静脉。CT静脉造影显示髂总静脉血流不畅且侧支血管发达。左髂总静脉起始处的严重狭窄与梅-图二氏综合征的诊断一致。
