未诊断的母体膈疝 - 一种管理困境。
Undiagnosed maternal diaphragmatic hernia - a management dilemma.
机构信息
Department of Obstetrics and Gynaecology, Monash Medical Centre, Level 5, Clayton, Vic, 3168, Australia.
Department of Obstetrics and Gynecology, Monash University, 246 Clayton Road, Clayton, VIC, Australia.
出版信息
BMC Pregnancy Childbirth. 2018 Jun 15;18(1):237. doi: 10.1186/s12884-018-1864-4.
BACKGROUND
Maternal diaphragmatic hernias identified during pregnancy are rare and pose significant management challenges with regards to timing and mode of both delivery and hernia repair.
CASE PRESENTATION
We describe a case of a maternal diaphragmatic hernia diagnosed at 31 weeks gestation in the setting of acute upper abdominal pain. Due to no evidence of visceral compromise and a stable maternal condition, the patient was conservatively managed, allowing for further foetal maturation. Delivery by caesarean section occurred following concerns of malnutrition and partial bowel obstruction. This was followed by immediate surgical repair of the hernia. The patient had an uncomplicated recovery.
CONCLUSION
Maternal diaphragmatic hernias in pregnancy require multidisciplinary care and individualised management in order to allow for the optimal outcome for mother and foetus.
背景
妊娠期间发现的母体膈疝较为罕见，在分娩时机和疝修补方式的选择上存在显著的管理挑战。
病例介绍
我们描述了一例在 31 周妊娠时因急性上腹痛而诊断出的母体膈疝病例。由于没有内脏损伤的证据且母体状况稳定，患者接受了保守治疗，以促进胎儿进一步成熟。在出现营养不良和部分肠梗阻的担忧后，行剖宫产分娩。随后立即进行了疝修补手术。患者恢复顺利。
结论
妊娠合并膈疝需要多学科的护理和个体化的管理，以实现母婴的最佳结局。
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