Troyano-Luque Juan, Padilla-Pérez Ana, Martínez-Wallin Ingrid, Alvarez de la Rosa Margarita, Mastrolia Salvatore Andrea, Trujillo José Luis, Pérez-Medina Tirso
Department of Obstetrics and Gynecology, Ultrasound and Fetal Medicine Unit, University Hospital of Canary Islands, Ctra. Ofra, s/n, Santa Cruz de Tenerife, 38320 San Cristóbal de La Laguna, Spain.
Department of Obstetrics and Gynecology, Ultrasound and Fetal Medicine Unit, University Hospital of Canary Islands, Ctra. Ofra, s/n, Santa Cruz de Tenerife, 38320 San Cristóbal de La Laguna, Spain ; Department of Obstetrics and Gynecology, School of Medicine, University Hospital Policlinico of Bari and University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy.
Case Rep Obstet Gynecol. 2014;2014:714271. doi: 10.1155/2014/714271. Epub 2014 Sep 30.
The aims of this study were to present and discuss ultrasound findings of prenatal fetal cholelithiasis in two cases with different etiology and evolution. Case 1: a pregnant woman from sub-Saharan Africa, suffering from Lyme disease, was treated with ceftriaxone sodium. Six weeks later, biliary sludge associated with polyhydramnios was detected in the fetus and the fetal growth percentile was 14. Emergency caesarean was performed at 36 weeks of gestation due to fetal distress. Biliary sludge persists in the two-and-a-half-year-old child. Case 2: the fetus of a Caucasian woman with normal pregnancy showed multiple cholelithiasis associated with polyhydramnios at 31 weeks of gestation. At 39 weeks and 4 days, cesarean section was performed due to lack of dilation. The biliary disease resolved spontaneously at seven months of age, with no associated abnormalities. In conclusion, prenatal diagnosis of cholelithiasis is straightforward, but prognosis cannot be defined yet. Serious complications do not arise in 70% of cases, but severe diseases may ensue in 20%. Persistence of cholelithiasis after one year of age results in cholelithiasis in childhood and beyond. Biliary sludge is associated with worse prognosis than cholelithiasis when it appears before 28 weeks of gestation.
本研究的目的是展示并讨论两例病因和演变过程不同的胎儿产前胆石症的超声检查结果。病例1：一名来自撒哈拉以南非洲的孕妇，患有莱姆病，接受了头孢曲松钠治疗。六周后，在胎儿中检测到与羊水过多相关的胆泥，胎儿生长百分位数为14。由于胎儿窘迫，在妊娠36周时进行了急诊剖宫产。两岁半的孩子中胆泥持续存在。病例2：一名妊娠正常的白人女性胎儿在妊娠31周时显示出与羊水过多相关的多发胆石症。在39周零4天时，由于宫口未开进行了剖宫产。胆病在七个月大时自发消退，无相关异常。总之，胆石症的产前诊断很直接，但预后尚无法确定。70%的病例不会出现严重并发症，但20%的病例可能会出现严重疾病。一岁后胆石症持续存在会导致儿童期及以后的胆石症。当胆泥在妊娠28周前出现时，其预后比胆石症更差。
