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惊险一刻:前置血管患者剖宫产时的切口位置重要吗?一例病例报告。

A close call: does the location of incision at cesarean delivery matter in patients with vasa previa? A case report.

作者信息

Neuhausser Werner M, Baxi Laxmi V

机构信息

Division of Reproductive Endocrinology & Infertility, Beth Israel Deaconess Medical Center/Boston IVF, Harvard Medical School, Boston, MA, USA.

Adjunct Professor Ob-Gyn, New York University School of Medicine, New York, NY, USA ; Professor Emerita, Clinical Obstetrics and Gynecology, Columbia University, New York, NY, USA.

出版信息

F1000Res. 2013 Dec 5;2:267. doi: 10.12688/f1000research.2-267.v1. eCollection 2013.

Abstract

We present here a case of vasa previa in a multipara, diagnosed at the time of her late second trimester ultrasonogram. The patient subsequently underwent an elective cesarean section after 37 weeks gestation, giving birth to a healthy child with an uneventful post-partum, neonatal and infant course. At the time of cesarean section, the incision was gradually deepened in layers through the myometrium by utmost care allowing the amniotic sac to protrude through the uterine incision hereby avoiding laceration of the vasa previa and its branches. Fetal exsanguination and a need for blood transfusion as well as a possible adverse neonatal course were therefore avoided.

摘要

我们在此呈现一例经产妇前置血管的病例,该病例在孕中期晚期超声检查时被诊断出来。患者随后在妊娠37周后接受了择期剖宫产,产下一名健康婴儿,产后、新生儿期及婴儿期过程均顺利。剖宫产时,通过极其小心地逐层逐渐加深子宫肌层切口,使羊膜囊从子宫切口处突出,从而避免了前置血管及其分支的撕裂。因此避免了胎儿失血、输血需求以及可能出现的不良新生儿病程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a18d/4103493/5caaf7b6f060/f1000research-2-3140-g0000.jpg

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