Dr Syeda Sayeeda, Associate Professor, Department of Fetomaternal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh: E-mail:
Mymensingh Med J. 2021 Jan;30(1):238-242.
Klippel-Trenaunay Syndrome (KTS) is a rare congenital disease characterized by a triad of cutaneous hemangioma (port-wine stain), varicose veins and bone or soft tissue hypertrophy. Cases of pregnancy complicated by KTS are rare and are associated with an increased risk of thrombo-embolic phenomena and hemorrhage. In this case, 33 years old woman, Para 1 gravida 2 (P1G2) with history of previous cesarean section and diagnosed case of KTS was presented in labour emergency of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh at 36+ weeks of gestation with labour pain. She had also a prominent hypertrophy and multiple venous varicosities on both her lower limbs; more marked on left. Her MRI done just before pregnancy revealed few prominent veins in both adnexa particularly on the left with normal caliber ovarian veins and unremarkable other pelvic structures and excludes pelvic congestion syndrome. USG done at her 35 weeks of gestation had shown numerous dilated and tortuous vessels in the parametrium, indicating pelvic congestion. Emergency caesarean section was done under spinal anesthesia. There was no postpartum hemorrhage (PPH). She was discharged along with her baby without any complication on her 4th postoperative day. Successful management of patients with KTS requires multidisciplinary team approach.
克莱佩特-特伦纳恩综合征(KTS)是一种罕见的先天性疾病,其特征为皮肤血管瘤(葡萄酒色斑)、静脉曲张和骨或软组织肥大三联征。妊娠合并 KTS 的病例很少见,且与血栓栓塞现象和出血的风险增加有关。本病例为 33 岁女性,P1G2,有剖宫产史,诊断为 KTS。她在孕 36+周时因临产紧急入住孟加拉国达卡的孟加拉国谢赫·穆吉布·医学大学(BSMMU),有临产痛。她的双下肢有明显的肥大和多处静脉静脉曲张,左侧更为明显。她在妊娠前做的 MRI 显示双侧附件有几条明显的静脉,特别是左侧,卵巢静脉正常,盆腔其他结构无异常,排除盆腔淤血综合征。她在孕 35 周时做的超声检查显示子宫旁有许多扩张和扭曲的血管,提示存在盆腔淤血。在脊髓麻醉下紧急行剖宫产术,无产后出血(PPH)。她在术后第 4 天与婴儿一起无任何并发症出院。成功管理 KTS 患者需要多学科团队方法。