胎儿纤连蛋白检测在短宫颈三胎妊娠管理中的应用。
The use of fetal fibronectin testing in the management of a triplet pregnancy with a short cervix.
作者信息
Morriss Alexandra Karin, Smout Elizabeth, Shennan Andrew
机构信息
Maternal and Fetal Research Unit, King's College London, London, UK.
出版信息
BMJ Case Rep. 2011 Jul 27;2011:bcr0220113846. doi: 10.1136/bcr.02.2011.3846.
Following in vitro fertilisation treatment, a 40-year-old woman was expecting trichorionic, triamniotic triplets. Her cervix shortened from 34 mm at 16(+5) weeks to 16 mm at 20(+5) weeks, a risk reported with 100% delivery before 28 weeks gestation. She was admitted to hospital and at 24(+1) weeks was given corticosteroids. From 21(+5) weeks her cervical length remained below 16 mm. However, weekly fetal fibronectin (fFN) tests were negative from 22(+5) weeks to delivery at 35(+5) weeks. This, along with an absence of symptoms, gave her doctors confidence to manage her as an outpatient from 28 weeks. At 33(+5) weeks she was diagnosed as having pre-eclampsia and three live births were delivered by prelabour caesarean section. Prior to delivery her cervical length was 10 mm and fFN test remained negative. There are no reports of outcome following a negative fFN with a short cervix in triplet pregnancies but fFN could be a useful tool, in conjunction with cervical length measurement, in the management of triplets.
在体外受精治疗后，一名40岁的女性怀了三绒毛膜、三羊膜囊三胞胎。她的宫颈长度在孕16（+5）周时为34毫米，到孕20（+5）周时缩短至16毫米，据报道这种情况有100%的概率在妊娠28周前分娩。她入院治疗，在孕24（+1）周时接受了皮质类固醇治疗。从孕21（+5）周起，她的宫颈长度一直低于16毫米。然而，从孕22（+5）周到孕35（+5）周分娩期间，每周的胎儿纤连蛋白（fFN）检测结果均为阴性。这一点，再加上没有症状，使她的医生有信心从孕28周起将她作为门诊患者进行管理。在孕33（+5）周时，她被诊断为子痫前期，并通过临产前剖宫产分娩了三个活产婴儿。分娩前她的宫颈长度为10毫米，fFN检测仍为阴性。对于三胎妊娠中宫颈短且fFN检测为阴性后的结局，目前尚无报道，但fFN结合宫颈长度测量，可能是管理三胞胎的一个有用工具。
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