Sakamoto A, Matsuo K, Kawai K, Yoshida K, Fukuda K, Nakano M, Nakatani A, Tsuchiyama H, Tagawa H
2nd Department of Pathology, Nagasaki University, School of Medicine, Japan.
Acta Pathol Jpn. 1987 Sep;37(9):1527-35. doi: 10.1111/j.1440-1827.1987.tb02274.x.
Three rare autopsy cases of fetal ascites were presented and the etiology of each case was described. Case 1 was a male neonate, delivered by cesarean section at 32 weeks' gestation, and died of respiratory failure. The abdomen was remarkably distended with 1020 ml of ascites. The etiology of Case 1 remained unknown even after macroscopic and microscopic examinations. We considered this as "idiopathic" fetal ascites. Case 2 was a female neonate, delivered at 31 weeks' gestation, with marked abdominal distension and cyanosis. Autopsy revealed 435 ml of ascites, and she was considered to have had "polysplenia syndrome" with cardiovascular malformations. Intrauterine heart failure due to cardiac anomalies was thought to be the cause of this ascites. In case 3 embryotomy was carried out under the diagnosis of fetal ascites by ultrasound examination at 22 weeks' gestation. An urachal cyst connected to the dilated urinary bladder and deficiency of musculature of the abdominal wall composed of loose connective tissue with calcification were observed. The abdominal wall was ruptured and 1,960 ml of ascites was measured. Polycystic kidney with renal dysplasia was also found. Case 3 showed "Prune-Berry syndrome" and fetal ascites may have arisen from these anomalies.
本文报告了三例罕见的胎儿腹水尸检病例，并对每个病例的病因进行了描述。病例1为一名男性新生儿，孕32周剖宫产出生，死于呼吸衰竭。腹部明显膨隆，有1020毫升腹水。即使经过大体和显微镜检查，病例1的病因仍不明确。我们将此视为“特发性”胎儿腹水。病例2为一名女性新生儿，孕31周出生，有明显腹胀和发绀。尸检发现有435毫升腹水，她被认为患有伴有心血管畸形的“多脾综合征”。心脏异常导致的宫内心力衰竭被认为是这种腹水的原因。病例3在孕22周时经超声检查诊断为胎儿腹水后进行了胚胎切开术。观察到一个与扩张膀胱相连的脐尿管囊肿，以及由疏松结缔组织构成且有钙化的腹壁肌肉组织缺失。腹壁破裂，测得腹水1960毫升。还发现了多囊肾伴肾发育不良。病例3表现为“梅干腹综合征”，胎儿腹水可能由这些异常引起。
