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双绒毛膜双羊膜囊双胎妊娠选择性终止后脐动脉血栓形成:一例报告

Umbilical Artery Thrombosis After Selective Termination in Dichorionic Diamniotic Twin Pregnancy: A Case Report.

作者信息

Liu Hongyan, Zeng Zhaomin, Liao Hua, Hu Qing, Yu Haiyan

机构信息

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People's Republic of China.

出版信息

Int J Womens Health. 2023 Aug 10;15:1327-1332. doi: 10.2147/IJWH.S423242. eCollection 2023.

Abstract

INTRODUCTION

Umbilical artery thrombosis is a rare complication associated with poor perinatal outcomes. The incidence of umbilical artery thrombosis in pregnancy is estimated from 0.0025% to 0.045%. Prenatal screening and diagnosis of umbilical artery thrombosis is usually performed by ultrasonography. Up to now, no treatment consensus has been achieved.

CASE PRESENTATION

We present a case of dichorionic diamniotic twin pregnancy complicated with selective termination of one twin with lymphoid cystic tumor at 14 weeks and 2 days of gestation and the alive twin occurred single umbilical artery thrombosis at 35 weeks and 6 days of gestation. The emergency cesarean section was performed after emergency admission. A healthy male baby was delivered weighing 2690g with Apgar scores of 10 and 10 at 1 and 5 minutes, respectively, whereas the dead fetus weighed 10 g. Thrombosis was observed throughout one of the umbilical artery of the alive fetus. The woman and the infant are followed up closely and both in good condition.

CONCLUSION

The number and morphology of umbilical arteries should be carefully observed during pregnancy. Individualized management of umbilical artery thrombosis should be based on clinical conditions. Timely termination of pregnancy if necessary could be suitable to improve adverse pregnancy outcomes.

摘要

引言

脐动脉血栓形成是一种罕见的并发症,与围产期不良结局相关。妊娠期间脐动脉血栓形成的发生率估计为0.0025%至0.045%。脐动脉血栓形成的产前筛查和诊断通常通过超声检查进行。到目前为止,尚未达成治疗共识。

病例报告

我们报告一例双绒毛膜双羊膜囊双胎妊娠病例,在妊娠14周2天时选择性终止其中一胎,该胎患有淋巴样囊性肿瘤,存活胎儿在妊娠35周6天时发生单脐动脉血栓形成。紧急入院后行急诊剖宫产。娩出一名健康男婴,体重2690g,1分钟和5分钟时阿氏评分分别为10分和10分,而死胎体重10g。在存活胎儿的一条脐动脉全程观察到血栓形成。对该妇女和婴儿进行密切随访,二者情况均良好。

结论

孕期应仔细观察脐动脉的数量和形态。脐动脉血栓形成的个体化管理应基于临床情况。必要时及时终止妊娠可能有助于改善不良妊娠结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e9d/10424691/a416fb0b15b5/IJWH-15-1327-g0001.jpg

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