Schwöbel M G, Sacher P, Stauffer U G
Chirurgische Klinik, Universitäts-Kinderspitals Zürich.
Geburtshilfe Frauenheilkd. 1989 Jul;49(7):658-61. doi: 10.1055/s-2008-1026673.
The diagnosis of a small intestinal obstruction was made prenatally between the 31st and 36th week of pregnancy in 7 patients with neonatal ileus. Five newborns showed a meconium-peritonitis, a meconium-ileus and the last a ileal atresia. These were compared with newborns with small intestinal obstruction, which had not been diagnosed prenatally. The analysis of our hospital information indicates, that primarily serious forms of ileus and intestinal perforations are diagnosed prenatally, whilst isolated small intestinal obstruction often avoids diagnosis. For this reason, diagnostic punctation of the foetal abdomen contribute little to the establishment of the etiology of the obstruction and should be avoided. On the other hand, punctation of a foetal ascites can, through pressure reduction of the abdomen, lengthen the duration of pregnancy and permit a spontaneous birth.
7例新生儿肠梗阻患者在妊娠31至36周时于产前确诊。5例新生儿表现为胎粪性腹膜炎、胎粪性肠梗阻,最后1例为回肠闭锁。将这些病例与产前未确诊的小肠梗阻新生儿进行比较。我院信息分析表明,产前主要诊断出严重形式的肠梗阻和肠穿孔,而孤立性小肠梗阻常难以诊断。因此,胎儿腹部穿刺对确定梗阻病因作用不大,应避免进行。另一方面,胎儿腹水穿刺可通过减轻腹部压力延长孕期并允许自然分娩。