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胸腔羊膜分流术后因胎儿活动导致导管移位至羊膜腔

Catheter Displacement Into the Amniotic Cavity by Fetal Movement After Thoracoamniotic Shunting.

作者信息

Katsura Daisuke, Inatomi Ayako, Tokoro Shinsuke, Tsuji Shunichiro, Murakami Takashi

机构信息

Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, JPN.

出版信息

Cureus. 2024 Sep 30;16(9):e70570. doi: 10.7759/cureus.70570. eCollection 2024 Sep.

Abstract

Thoracoamniotic shunting (TAS) is an effective treatment for fetal pleural effusion. We report a case of bilateral fetal pleural effusion in which catheter displacement into the amniotic cavity occurred due to fetal movement after TAS. Initially, left TAS was performed twice using a 60-mm catheter, resulting in displacement and the catheter being pinched between the fetal fingers. Subsequently, a 50-mm catheter was employed for left TAS, which successfully prevented further displacement. Labor was induced at 35 weeks and three days of gestation due to an increase in right fetal pleural effusion. Following delivery, the infant was managed with directional positive airway pressure and drainage of the pleural effusion and remained stable on respiratory support. This case highlights the importance of tailoring catheter length and placement based on the thickness of the fetal chest wall to minimize displacement risks associated with fetal movement.

摘要

胸羊膜分流术(TAS)是治疗胎儿胸腔积液的有效方法。我们报告一例双侧胎儿胸腔积液病例,该病例在TAS术后因胎儿活动导致导管移入羊膜腔。最初,使用60毫米导管进行了两次左侧TAS,导致导管移位并被胎儿手指夹住。随后,采用50毫米导管进行左侧TAS,成功防止了进一步移位。由于右侧胎儿胸腔积液增加,在妊娠35周零三天时引产。分娩后,对婴儿进行定向气道正压通气和胸腔积液引流治疗,在呼吸支持下保持稳定。该病例强调了根据胎儿胸壁厚度调整导管长度和放置位置以尽量减少与胎儿活动相关的移位风险的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0df6/11524985/d57c2231a959/cureus-0016-00000070570-i01.jpg

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