Sharma Nalini, Das Rituparna, Salam Sushila, Jethani Roma, Singh Ahanthem Santa
Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.
J Reprod Infertil. 2017 Oct-Dec;18(4):390-392.
Various placental and cord abnormalities have been known to adversely affect the obstetric outcome. Circumvallate placenta and Battledore insertion of the umbilical cord are both rare and known to be associated with poor obstetric outcome individually.
In this case report, the woman presented at 8 months of gestation with preeclampsia with IUFD to North Easter Indira Gandhi Regional Institute of Health and Medical Science Shillong on 22/7/16 and delivered a macerated fetus vaginally. After delivery, examination revealed both a circumvallate placenta and Battledore insertion of umbilical cord. This might have attributed to preeclampsia and ultimately IUFD in this case as she had no other identifiable cause for IUFD.
If such placental and cord abnormalities are suspected or diagnosed antenatally by ultrasonography, the pregnancy should be regarded as high risk. Such woman would require more stringent follow up in the antenatal period and continuous intrapartum monitoring to avoid any catastrophe and to achieve a favorable maternal and fetal outcome.
已知各种胎盘和脐带异常会对产科结局产生不利影响。轮廓状胎盘和球拍状脐带插入均较为罕见,且各自都与不良产科结局相关。
在本病例报告中,该名女性于妊娠8个月时因子痫前期合并胎死宫内,于2016年7月22日就诊于西隆的东北英迪拉·甘地区域卫生与医学科学研究所,并经阴道分娩出一个浸软胎儿。分娩后检查发现既有轮廓状胎盘又有球拍状脐带插入。在本病例中,这可能是子痫前期的原因,最终导致了胎死宫内,因为她没有其他可识别的胎死宫内原因。
如果通过超声产前怀疑或诊断出此类胎盘和脐带异常,应将该妊娠视为高危妊娠。此类女性在孕期需要更严格的随访以及持续的产时监测,以避免任何灾难的发生,并实现良好的母婴结局。