Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore.
Department of Obstetrics and Gynecology, National University Hospital, Singapore.
J Perinatol. 2014 Jan;34(1):78-80. doi: 10.1038/jp.2013.124.
We report a neonate who presented antenatally with fetal ascites and fetal anemia. The cause of this remained uncertain until 2 weeks later when bowel dilatation was noted on antenatal ultrasound. Clinical signs of intestinal obstruction became evident after delivery, and ileal atresia was found at laparotomy, which was resected with primary anastomosis. Recent reports in the literature have suggested a possible connection between fetal ascites, anemia and dilated bowel with neonatal intestinal obstruction. In these cases and ours, the likely sequence of events was that of in utero midgut volvulus with bleeding into ischemic bowel, hemorrhagic ascites resulting in fetal anemia and progressive bowel dilatation occurring as a consequence of intestinal atresia. Early treatment in our patient with intrauterine blood transfusion may have altered the natural history of her condition, allowing pregnancy to progress to term with a subsequent improved outcome.
我们报告了一例新生儿，其在产前表现为胎儿腹水和胎儿贫血。直到 2 周后，产前超声检查发现肠扩张，其病因仍不确定。分娩后出现肠梗阻的临床症状，剖腹探查发现回肠闭锁，行肠切除端端吻合术。文献中的近期报道表明，胎儿腹水、贫血和肠扩张与新生儿肠梗阻之间可能存在关联。在这些病例和我们的病例中，可能的事件顺序是胎儿中肠旋转不良伴出血进入缺血性肠，导致腹水导致胎儿贫血，以及肠闭锁导致进行性肠扩张。我们的患者在宫内输血的早期治疗可能改变了她病情的自然进程，使妊娠能够足月进行，从而改善了后续结果。
