Haga Mitsuhiro, Itoh Kanako, Horikoshi Tsuguhiro, Namba Fumihiko, Kabe Kazuhiko
Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
AJP Rep. 2021 Mar;11(2):e76-e79. doi: 10.1055/s-0041-1727288. Epub 2021 May 27.
Recent studies have shown favorable outcomes for intra-abdominal umbilical vein varices (IUVVs) in term neonates who have no other complications. Little is known, however, about the prognosis of IUVVs in preterm neonates. We encountered a case of IUVV in an extremely low-birth-weight infant who developed severe consumptive coagulopathy after birth. The patient's coagulation test normalized as the varix spontaneously obstructed. Although life-threatening hemorrhagic complications were avoided, a cerebellum hemorrhage was found in the brain magnetic resonance imaging at the term-equivalent age. In a literature survey, coagulopathy was reported in 4 out of 15 infants with IUVVs born before 34 weeks of gestation, including our present case. Preterm infants with IUVVs may develop coagulopathy because of the prematurity of their coagulation-fibrinolysis systems. Attention should be given to the coagulation status of preterm neonates with IUVVs.
最近的研究表明，对于无其他并发症的足月儿，腹腔内脐静脉静脉曲张（IUVV）预后良好。然而，关于早产儿IUVV的预后知之甚少。我们遇到一例极低出生体重儿发生IUVV，出生后出现严重的消耗性凝血病。随着静脉曲张自发阻塞，患者的凝血试验恢复正常。虽然避免了危及生命的出血并发症，但在足月等效年龄的脑部磁共振成像中发现了小脑出血。在一项文献调查中，15例孕34周前出生的IUVV婴儿中有4例报告有凝血病，包括我们目前的病例。患有IUVV的早产儿可能因其凝血-纤溶系统不成熟而发生凝血病。应关注患有IUVV的早产儿的凝血状态。
