Kaneko Masatoki, Yamauchi Aya, Yamashita Rie, Sato Yuichiro, Kodama Yuki, Sameshima Hiroshi
Graduate School of Nursing Science, University of Miyazaki, Miyazaki, Japan.
Department of Obstetrics and Gynecology, University of Miyazaki, Miyazaki, Japan.
J Obstet Gynaecol Res. 2015 Nov;41(11):1839-42. doi: 10.1111/jog.12828. Epub 2015 Sep 30.
We report a case of marked elevation of the procalcitonin level in umbilical blood and neonatal blood at birth. The mother did not perceive fetal motion. Antepartum fetal heart rate monitoring showed a loss of variability and absence of acceleration. No fetal breathing movement, fetal movement, or fetal tone were observed by ultrasonography. The female neonate was delivered by cesarean section at 25 weeks of gestation, with birthweight 774 g. The umbilical arterial pH value at birth was 7.29. Mild elevation in interleukin-6 and tumor necrosis factor-α in umbilical blood were observed. Cytochrome c showed a high level in umbilical and neonatal blood at birth. Placental histopathology revealed multiple fetal vessel thrombosis in the large stem villi and chorionic vessels. The neonate showed no infectious signs throughout the neonatal period. Computed tomography at 3 months of age revealed atrophy in the cerebrum and cerebellum. At 1 year after birth, the infant showed spastic quadriplegia. In this case, antepartum asphyxia due to fetal vessel thrombosis may have influenced the elevation of procalcitonin level in umbilical blood and neonatal blood at birth.
我们报告一例出生时脐血和新生儿血液中降钙素原水平显著升高的病例。母亲未感觉到胎动。产前胎儿心率监测显示变异性丧失且无加速。超声检查未观察到胎儿呼吸运动、胎儿运动或胎儿张力。该女婴于妊娠25周时剖宫产出生，出生体重774克。出生时脐动脉pH值为7.29。观察到脐血中白细胞介素-6和肿瘤坏死因子-α轻度升高。出生时脐血和新生儿血液中的细胞色素c水平较高。胎盘组织病理学显示大的主干绒毛和绒毛膜血管中有多处胎儿血管血栓形成。新生儿在整个新生儿期均未出现感染迹象。3个月大时的计算机断层扫描显示大脑和小脑萎缩。出生1年后，婴儿出现痉挛性四肢瘫痪。在本病例中，胎儿血管血栓形成导致的产前窒息可能影响了出生时脐血和新生儿血液中降钙素原水平的升高。
