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孕期巨大绒毛膜下血肿:一例报告。

A large subchorionic hematoma in pregnancy: A case report.

作者信息

Liu Yu, Tong An, Qi Xiaorong

机构信息

Department of Gynecology and Obstetrics, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital.

West China School of Medicine, Sichuan University, Chengdu, PR China.

出版信息

Medicine (Baltimore). 2020 May 29;99(22):e20280. doi: 10.1097/MD.0000000000020280.

Abstract

INTRODUCTION

Subchorionic hematoma (SCH) is a rare type of intrauterine hematoma, usually with limited impact on fetuses and pregnant women. But massive hematoma causes significant space occupying effect, affects blood supply of the fetus and finally may lead to fetus demise.

PATIENT CONCERNS

In this case report, we reported a 22-year-old pregnant woman presented to our hospital with complaint of irregular lower abdominal pain.

DIAGNOSIS

Ultrasonography and magnetic resonance imaging confirmed an intrauterine mass with a compressed growth-restricted fetus.

INTERVENTIONS

The patient underwent diseases induced labor after confirmation of fetus demise by ultrasonography.

OUTCOMES

Histopathological examination of the mass revealed a SCH.

CONCLUSION

Though small SCH can be found in quite a few pregnant women and is usually harmless, enormous hematoma can result in adverse pregnancy outcomes. It may be difficult, in some cases, to differentiate it from uterine tumors or placental tumors by means of ultrasonography and magnetic resonance imaging, especially when the mass is hyperechoic under ultrasonography. This case report stresses the importance of regular examinations of pregnant women.

摘要

引言

绒毛膜下血肿(SCH)是一种罕见的宫内血肿类型,通常对胎儿和孕妇影响有限。但巨大血肿会产生显著的占位效应,影响胎儿血供,最终可能导致胎儿死亡。

患者情况

在本病例报告中,我们报道了一名22岁孕妇因下腹部不规则疼痛前来我院就诊。

诊断

超声检查和磁共振成像证实宫内有一肿块,胎儿生长受限且受压。

干预措施

在超声检查确认胎儿死亡后,患者接受了引产。

结果

肿块的组织病理学检查显示为绒毛膜下血肿。

结论

尽管相当一部分孕妇可发现小的绒毛膜下血肿,且通常无害,但巨大血肿可导致不良妊娠结局。在某些情况下,通过超声检查和磁共振成像可能难以将其与子宫肿瘤或胎盘肿瘤区分开来,尤其是当肿块在超声检查下呈高回声时。本病例报告强调了孕妇定期检查的重要性。

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