Kojima Yuki, Ozawa Katsusuke, Sugibayashi Rika, Wada Seiji, Sago Haruhiko
Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
J Obstet Gynaecol Res. 2018 Jul;44(7):1322-1325. doi: 10.1111/jog.13662. Epub 2018 May 23.
The neonatal prognosis in gastroschisis is generally good; however, intrauterine fetal death (IUFD) and nonreassuring fetal status (NRFS) sometimes occur in fetal cases of gastroschisis. Previously, we reported stomach herniation as a possible risk factor for IUFD or NRFS in fetuses with gastroschisis. We report a case of fetal gastroschisis showing stomach herniation and increased velocity of the umbilical venous (UV) flow the day before NRFS by electronic fetal monitoring (EFM). A 27-year-old pregnant woman was followed up from 16 weeks' gestation due to fetal gastroschisis. At 33 + 1 weeks' gestation, EFM displayed a reassuring fetal state, while the ultrasound examination revealed fetal stomach herniation and an increased flow velocity of the UV in the abdomen. One day later, EFM displayed NRFS, and the patient underwent emergency caesarean section. This case showed stomach herniation preceding the occurrence of NRFS. Stomach herniation may be a predictor of NRFS in fetuses with gastroschisis.
腹裂新生儿的预后通常良好；然而，腹裂胎儿有时会发生宫内胎儿死亡（IUFD）和胎儿状况不良（NRFS）。此前，我们报道胃疝是腹裂胎儿发生IUFD或NRFS的一个可能危险因素。我们报告一例腹裂胎儿病例，在通过电子胎儿监护（EFM）出现NRFS的前一天，显示有胃疝且脐静脉（UV）血流速度增加。一名27岁孕妇因胎儿腹裂自妊娠16周起接受随访。妊娠33 + 1周时，EFM显示胎儿状态良好，而超声检查显示胎儿胃疝且腹部UV血流速度增加。一天后，EFM显示NRFS，患者接受了急诊剖宫产。该病例显示在NRFS发生之前出现了胃疝。胃疝可能是腹裂胎儿发生NRFS的一个预测指标。
