Katsura Daisuke, Moritani Suzuko, Tsuji Shunichiro, Hayashi Kaori, Yamada Kazutaka, Tokoro Shinsuke, Suzuki Kounosuke, Kimura Fuminori, Murakami Takashi
Department of Obstetrics and Gynecology, Shiga University of Medical Science Hospital, Setatsukinowa-cho, Otsu, Shiga 520-2192, Japan.
Department of Diagnostic Pathology, Shiga University of Medical Science Hospital, Setatsukinowa-cho, Otsu, Shiga 520-2192, Japan.
Case Rep Obstet Gynecol. 2019 Dec 19;2019:3768761. doi: 10.1155/2019/3768761. eCollection 2019.
Umbilical cord ulcer is related to fetal intestinal atresia or meconium; perforation of the ulcer causes fetal deterioration leading to fetal and neonatal death owing to fetal hemorrhage. However, to the best of our knowledge, a method to diagnose umbilical cord ulcer prenatally is not available. No reports exist about the prenatal findings before perforation of umbilical cord ulcer using ultrasonography. We encountered two cases of umbilical cord ulcer showing ultrasonographic finding of a linear echo around the umbilical cord. Umbilical cord ulcers with an exposed umbilical cord artery in the first case and with perforation of the artery in the second case were diagnosed postnatally. When we encounter such ultrasonographic finding, especially with polyhydramnios and high amniotic bile acid concentration in cases of fetal intestinal atresia, risk of perforation of the umbilical cord ulcer should be included in the differential diagnosis.
脐带溃疡与胎儿肠道闭锁或胎粪有关;溃疡穿孔会导致胎儿状况恶化,因胎儿出血而导致胎儿和新生儿死亡。然而,据我们所知,目前尚无产前诊断脐带溃疡的方法。关于使用超声检查在脐带溃疡穿孔前的产前发现尚无报道。我们遇到了两例脐带溃疡病例,超声检查显示脐带周围有线性回声。第一例脐带溃疡伴有暴露的脐动脉,第二例伴有动脉穿孔,均在产后确诊。当我们遇到这种超声表现时,尤其是在胎儿肠道闭锁病例中伴有羊水过多和羊水胆汁酸浓度升高时,在鉴别诊断中应考虑脐带溃疡穿孔的风险。