Zhang Bili, Zhang Xueqin, Wang Yijing
Dept. of Obstetrics, Xiamen Maternity and Child Health Care Hospital, Xiamen 361003, China.
Iran J Public Health. 2018 Jul;47(7):1034-1036.
Idiopathic chylous ascites in pregnancy is extremely rare. Here, we report a 24-yr-old patient with idiopathic chylous ascites in pregnancy. The patient was hospitalized in Xiamen Maternity and Child Health Care Hospital, Xiamen China in 2014 due to G1P0 intrauterine pregnancy 39+2 week, LOA, and time of labor. The patient gave birth to a live baby boy (3.6 kg) by spontaneous vaginal delivery, with complete delivery of placenta. Three hours after delivery, the patient reported abdominal distension and pain, as well as asthma. Later, milky white liquid was drawn from left lower abdomen by puncture. Exploratory laparotomy was performed, and 800 ml milky white liquid was drawn from the abdominal cavity. Subsequently, drainage tube was placed in the abdominal cavity, and the abdomen was closed. After the surgery, the patient was given low-fat diet, supplemented with parenteral nutrition support and intravenous injection of antibiotics. Extubation was performed on day 3. On day 7 after surgery, the mother and baby left the hospital without any health problems. No abnormality was observed during six months of follow-ups. Idiopathic chylous ascites in pregnancy may be related to congenital lymphatic system dysplasia, and directly caused by chylous flow from ducts into abdominal cavity induced by progesterone during pregnancy or pressure from enlarged uterus during late pregnancy. After pregnancy, the disease is cured by the release of disease cause and the reduction of thoracic duct pressure.
妊娠特发性乳糜腹水极为罕见。在此，我们报告一例24岁妊娠合并特发性乳糜腹水的患者。该患者于2014年因孕1产0、宫内妊娠39 + 2周、枕左前位待产入住中国厦门妇幼保健院。患者经阴道自然分娩一活男婴（3.6 kg），胎盘完整娩出。产后3小时，患者诉腹胀、腹痛及气喘。随后经穿刺从左下腹抽出乳白色液体。行剖腹探查术，从腹腔抽出800 ml乳白色液体。随后在腹腔置入引流管，关闭腹腔。术后，患者给予低脂饮食，并辅以肠外营养支持及静脉注射抗生素。术后第3天拔管。术后第7天母婴无任何健康问题出院。随访6个月未见异常。妊娠特发性乳糜腹水可能与先天性淋巴系统发育不良有关，直接原因可能是孕期孕激素导致乳糜从淋巴管流入腹腔，或妊娠晚期子宫增大产生的压迫。产后，病因解除及胸导管压力降低后疾病得以治愈。
