Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan.
Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2021 Mar;60(2):355-358. doi: 10.1016/j.tjog.2021.01.016.
We reported a fetus that presenting with persistent left superior vena cava (PLSVC), polyhydramnios, and a small gastric bubble during prenatal examination and identified VACTERL association after birth.
A 34-year-old woman underwent amniocentesis at 18 weeks of gestation because of advanced maternal age and the result was normal. Subsequently, an ultrasound revealed single umbilical artery (SUA) at 21 weeks of gestation. She received a detailed fetal anatomy survey that presented the same findings and PLSVC. A small visible gastric bubble was noted at that time, and the other organs were unremarkable. Polyhydramnios was identified at 30 weeks of gestation and amnioreduction was subsequently performed at 32 weeks of gestation. However, polyhydramnios was persisted despite amnioreduction and intrauterine growth restriction was also detected. A cesarean section was performed because of fetal distress at 36 + 2 weeks, and a 1832-g female baby was delivered. Pre-axial polydactyly at left thumb, SUA and esophageal atresia with distal tracheoesophageal fistula (TEF) were identified after birth. The neonate died at age of 4 days because of surgical complication following esophageal anastomosis.
Prenatal diagnosis of PLSVC associated with polyhydramnios and a small gastric bubble may indicate esophageal atresia with TEF, and further examination for associated syndromes such as VACTERL association is warranted.
我们报道了一例在产前检查中表现出永存左上腔静脉（PLSVC）、羊水过多和小胃泡的胎儿，并在出生后发现了 VACTERL 协会。
一位 34 岁的女性因高龄接受了 18 周的羊膜穿刺术，结果正常。随后，在 21 周的超声检查中发现单脐动脉（SUA）。她接受了详细的胎儿解剖检查，结果显示相同的发现和 PLSVC。当时注意到一个小的可见胃泡，其他器官无明显异常。在 30 周时发现羊水过多，并在 32 周时进行了羊水减少术。然而，尽管进行了羊水减少术，羊水过多仍持续存在，同时还发现了宫内生长受限。由于胎儿窘迫，在 36+2 周时进行了剖宫产，分娩出一名 1832 克的女婴。出生后发现左拇指多趾畸形、SUA 和食管闭锁伴远端气管食管瘘（TEF）。新生儿在食管吻合术后因手术并发症于出生后 4 天死亡。
产前诊断 PLSVC 伴羊水过多和小胃泡可能提示食管闭锁伴 TEF，并需要进一步检查是否存在 VACTERL 协会等相关综合征。
