Kaido Yoshitaka, Kikuchi Akihiko, Kanasugi Tomonobu, Oyama Rie, Sugiyama Toru
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505 Japan.
Springerplus. 2014 Mar 17;3:146. doi: 10.1186/2193-1801-3-146. eCollection 2014.
We reported a very rare case with placentomegaly and markedly-dilated chorionic vessels. A 23-year-old Japanese pregnant woman was referred to our hospital at 32 weeks of gestation because of suspected dilatation of the umbilical vein. Ultrasound revealed fetal growth restriction with no fetal anomalies. The placenta was thick. The umbilical cord had two arteries and one vein, and marginal insertion of the umbilical cord in the placenta was suspected. A lot of remarkably tortuous tubular structures were observed on the surface of the placenta. Slow blood flow, indemonstrable with color Doppler, was observed within them. Labor started suddenly and progressed very rapidly at 33 weeks of gestation. A female infant weighing 1524 g was delivered. The infant had no malformations. However, she showed hypotension, anemia and DIC and required blood transfusion. The placenta was very large, weighing 1416 g. On the fetal surface, numerous dilated and tortuous vessels were observed, arising from a vein that was connected to the umbilical vein. These venous channels were dilated and tortuous and led into the placenta. In conclusion, prenatal diagnosis of placentomegaly and markedly-dilated chorionic vessels requires assessment of growth, anemia and DIC of the fetus and the newborn infant.
我们报告了一例极为罕见的胎盘肿大且绒毛血管显著扩张的病例。一名23岁的日本孕妇在妊娠32周时因怀疑脐静脉扩张被转诊至我院。超声检查显示胎儿生长受限但无胎儿畸形。胎盘增厚。脐带中有两条动脉和一条静脉，怀疑脐带边缘附着于胎盘。在胎盘表面观察到许多明显迂曲的管状结构。彩色多普勒显示其内血流缓慢。妊娠33周时突然开始分娩且进展迅速。一名体重1524克的女婴出生。该婴儿无畸形。然而，她出现低血压、贫血和弥散性血管内凝血，需要输血。胎盘非常大，重1416克。在胎儿表面，观察到许多扩张迂曲的血管，起源于一条与脐静脉相连的静脉。这些静脉通道扩张且迂曲并延伸至胎盘。总之，产前诊断胎盘肿大和显著扩张的绒毛血管需要评估胎儿及新生儿的生长、贫血和弥散性血管内凝血情况。
