胎儿在子宫内的致死性中风。

Lethal fetal stroke in utero.

机构信息

Dianthus Maternal Fetal Medicine Clinic, Taipei City, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2013 Jun;52(2):264-6. doi: 10.1016/j.tjog.2013.04.019.

DOI:10.1016/j.tjog.2013.04.019

PMID:23915862

Abstract

OBJECTIVE

Fetal intracranial hemorrhage (ICH) in utero is a rare complication of pregnancy associated with subsequent neurological sequelae or fetal death.

CASE REPORT

A 34-year-old woman with Crohn's disease presented at 36 weeks' gestation due to decreased fetal movement. Fetal heart-rate tracing indicated poor beat-to-beat variability. In addition, a Doppler ultrasonography suggested a prenatal stroke with evidences of ICH, reverse-end diastolic velocity of the middle cerebral artery, and a persistent distended bladder. A nonaggressive treatment option was chosen after counseling about the unfavorable prognosis. However, 22 hours after her admission, intrauterine fetal death occurred.

CONCLUSION

Fetal ICH in utero might be a rare yet lethal complication of Crohn's disease in pregnancy.

摘要

目的

胎儿颅内出血（ICH）是一种罕见的妊娠并发症，可导致后续的神经后遗症或胎儿死亡。

病例报告

一位 34 岁的克罗恩病女性患者，在妊娠 36 周时因胎动减少就诊。胎儿心率描记图显示搏动性差。此外，多普勒超声提示产前卒中合并 ICH 证据，大脑中动脉反向舒张末期流速（reverse-end diastolic velocity，REDDV）增高，且膀胱持续膨胀。在告知预后不佳后，选择了非侵袭性治疗方案。然而，入院 22 小时后，胎儿宫内死亡。