Holmen Sarah M, Bakhshi Tiki, Molina Maria M, Weir Larissa F
Department of Obstetrics and Gynecology, San Antonio Military Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, TX 78234.
Mil Med. 2016 Oct;181(10):e1398-e1399. doi: 10.7205/MILMED-D-15-00588.
Chorioamniotic membrane separation (CMS) is a rare finding that is commonly preceded by invasive fetal procedures. The presence of CMS can also be associated with uncommon maternal or fetal conditions as well as preterm delivery, amniotic band syndrome, umbilical cord complications, and fetal and neonatal death. It is classified as a high-risk antepartum condition due to the significant fetal morbidity and mortality that may ensue.
A 40-year-old gravida 5 para 1212 at 35 weeks presented for antepartum fetal testing. Her antepartum course was complicated by di-di twin gestation, chronic hypertension, and advanced maternal age. A routine ultrasound (as part of the antepartum fetal testing) identified an incidental finding of CMS. The patient's only reported symptom was that of preterm contractions, without evidence of active labor, and other fetal testing was reassuring. She had a repeat cesarean section that day and the suspected etiology was preterm, premature rupture of membranes of Twin B that was seen on entry into the uterine cavity.
Chorioamniotic separation is a rare occurrence associated with significant adverse fetal outcomes. This is the first reported case of incidental diagnosis in a twin pregnancy during antepartum fetal surveillance testing. Our detection resulted in the delivery of late preterm, but otherwise healthy, twin neonates.
绒毛膜羊膜分离（CMS）是一种罕见的情况，通常发生在侵入性胎儿操作之后。CMS的出现也可能与不常见的母体或胎儿状况以及早产、羊膜带综合征、脐带并发症以及胎儿和新生儿死亡有关。由于可能随之而来的显著胎儿发病率和死亡率，它被归类为高危产前状况。
一名40岁、孕5产1212、孕35周的孕妇前来进行产前胎儿检查。她的产前过程因双绒毛膜双胎妊娠、慢性高血压和高龄产妇而复杂化。一次常规超声检查（作为产前胎儿检查的一部分）偶然发现了CMS。患者唯一报告的症状是早产宫缩，无活跃分娩迹象，其他胎儿检查结果令人放心。她当天接受了再次剖宫产，疑似病因是进入宫腔时发现的双胎B胎膜早破。
绒毛膜羊膜分离是一种罕见情况，与显著的不良胎儿结局相关。这是第一例在产前胎儿监测检查中双胎妊娠偶然诊断的报告病例。我们的检测导致了晚期早产但其他方面健康的双胎新生儿的分娩。
