Ewy G I, Kuruvilla A C
Children's Health Center, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013.
Am J Perinatol. 1988 Jul;5(3):251-2. doi: 10.1055/s-2007-999697.
Obstruction of the tracheobronchial tree in the fetus-newborn is well recognized with meconium-stained amniotic fluid, but this problem is not usually considered in the absence of meconium. In the case reported here, airway obstruction by a large mucous-like plug apparently developed in the context of severe oligohydramnios and fetal distress. The infant required resuscitation but it was initially impossible to expand the chest despite endotracheal intubation and positive pressure ventilation. The lung compliance changed abruptly at 6 minutes of age and breath sounds were audible unilaterally on the left. A chest radiograph confirmed an atelectatic right lung. After aspiration of a large plug, both lungs became normally aerated. Airway obstruction must be included in the differential diagnosis of respiratory distress occurring in the context of severe oligohydramnios.
胎儿-新生儿气管支气管树梗阻在羊水胎粪污染时已得到充分认识，但在无胎粪的情况下通常不考虑这个问题。在本文报道的病例中，一个大的黏液样栓子导致的气道梗阻显然是在严重羊水过少和胎儿窘迫的情况下发生的。婴儿需要复苏，但尽管进行了气管插管和正压通气，最初仍无法扩张胸部。婴儿6分钟大时肺顺应性突然改变，左侧可闻及单侧呼吸音。胸部X线片证实右肺肺不张。吸出一个大的栓子后，双肺恢复正常通气。在严重羊水过少的情况下发生的呼吸窘迫的鉴别诊断中必须考虑气道梗阻。
