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非侵入性胎儿心电图改善绒毛膜血管瘤胎儿结局:病例报告。

Non-invasive fetal electrocardiography ameliorates fetal outcome in chorioangioma: A case report.

机构信息

Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine.

出版信息

J Neonatal Perinatal Med. 2021;14(1):149-152. doi: 10.3233/NPM-190329.

Abstract

Chorioangioma is a rare vascular placental tumour. Large chorioangiomas are known to have many maternal and perinatal complications. The case of placental chorioangioma detected via ultrasound is presented. This paper is focused on non-invasive fetal electrocardiography (NI-FECG) clinical use for diagnosing fetal anemia in chorioangioma.A 22-year-old primigravida was admitted to the department of fetomaternal medicine at 30 weeks of gestation. She had threatened preterm labour, polyhydramnios, and breech presentation. The large echogenic mass of 77 mm×66 mm×83 mm, located in the uterine bottom, protruded into the amniotic cavity, and connected to the marginal sinus of the placenta was determined via ultrasound. The sinusoidal pattern of beat-to-beat variations was diagnosed via NI-FECG in spite of normal blood flow velocity in the fetal middle cerebral artery. Therefore, NI-FECG was superior in the detection of fetal anemia. The female baby weighing 1500 g and measuring 42 cm in length, with a head circumference of 30 cm and Apgar score 3⟶5, was delivered by caesarean section. The baby had severe anemia and respiratory distress syndrome.NI-FECG was a good option for the clinician for the timely and accurate diagnosis of fetal anemia and fetal compromise in placental chorioangioma.

摘要

绒毛膜血管瘤是一种罕见的胎盘血管肿瘤。已知大型绒毛膜血管瘤会导致许多母婴和围产儿并发症。本文介绍了通过超声检测到的胎盘绒毛膜血管瘤病例。本文重点介绍了无创胎儿心电图(NI-FECG)在诊断绒毛膜血管瘤胎儿贫血中的临床应用。

一名 22 岁的初产妇在妊娠 30 周时被收入胎儿-母体医学科。她有早产威胁、羊水过多和臀位。超声检查确定子宫底部有一个 77×66×83mm 的大回声团块,突入羊膜腔,与胎盘边缘窦相连。尽管胎儿大脑中动脉的血流速度正常,但通过 NI-FECG 诊断出窦性搏动的搏动变化模式,因此 NI-FECG 在检测胎儿贫血方面更具优势。女婴体重 1500g,长 42cm,头围 30cm,阿普加评分 3 ⟶ 5,通过剖宫产分娩。婴儿患有严重贫血和呼吸窘迫综合征。

NI-FECG 是临床医生及时准确诊断胎盘绒毛膜血管瘤胎儿贫血和胎儿窘迫的良好选择。

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