Ngai Ivan, Sheen Jean-Ju, Govindappagari Shravya, Garry David J
Montefiore Medical Center/Einstein Medical College, Bronx, New York, USA.
BMJ Case Rep. 2012 Sep 11;2012:bcr2012006859. doi: 10.1136/bcr-2012-006859.
Asymptomatic diaphragmatic hernias in reproductive-aged women are rare but pose significant morbidity for pregnancy. This is a case of a woman at 29 weeks' gestation with abdominal pain and shortness of breath. Five years prior she had been incidentally diagnosed with a small congenital diaphragmatic hernia of Bochdalek. Following preconception care, she opted against repair of the hernia prior to pregnancy due to lack of symptoms and no clear recommendation for repair from the surgeon. Imaging studies on emergency room presentation demonstrated a large herniation of viscera into her chest occupying her entire left chest with slight cardiac displacement. Through a multidisciplinary approach, she was stabilised and eventually delivered at 31 weeks due to worsening pulmonary function. The hernia was repaired postpartum. We recommend repair of any diaphragmatic hernia prior to conception to prevent significant maternal and fetal morbidity or mortality. A multidisciplinary approach allows for planning.
无症状的育龄女性膈疝较为罕见，但会给妊娠带来严重的发病风险。这是一例妊娠29周的女性，出现腹痛和呼吸急促症状。五年前，她偶然被诊断出患有小型Bochdalek先天性膈疝。经过孕前护理，由于没有症状且外科医生未明确建议进行修复，她选择在怀孕前不修复疝。急诊时的影像学检查显示大量内脏疝入胸腔，占据了整个左胸，心脏稍有移位。通过多学科方法，她的病情得到稳定，最终因肺功能恶化在31周时分娩。产后对疝进行了修复。我们建议在怀孕前修复任何膈疝，以预防严重的母婴发病或死亡。多学科方法有助于进行规划。
