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晚期羊膜破裂伴游离带情况下的良好新生儿结局:一例病例报告及文献综述

Favorable neonatal outcome following late-term amniotic membrane rupture with free-floating band: A case report and literature review.

作者信息

Wang Lan, Wang Zhengping, Tan Huayun

机构信息

Obstetrics Medical Center, Weifang People's Hospital, Shandong Second Medical University, Weifang City, Shandong Province, China.

Ultrasound Department, Weifang People's Hospital, Shandong Second Medical University, Weifang City, Shandong Province, China.

出版信息

Medicine (Baltimore). 2025 Jul 18;104(29):e43498. doi: 10.1097/MD.0000000000043498.

Abstract

RATIONALE

Amniotic band syndrome (ABS), or amniotic rupture sequence, is a rare congenital condition characterized by fibrous amniotic bands that may entangle fetal parts, leading to constriction, deformities, or even intrauterine demise. However, not all abnormalities of the amniotic membrane result in classical ABS. This case describes a late-term rupture of the amniotic membrane with a free-floating band, but without any evidence of fetal entanglement or malformation. The fetus had a favorable prognosis, suggesting a benign variant of amniotic membrane rupture rather than true ABS.

PATIENT CONCERNS

A 30-year-old primigravid woman with a history of polyhydramnios, who presented at 39+5 weeks of gestation with concerns of a floating echogenic band suggestive of amniotic membrane rupture and possible umbilical cord entanglement.

DIAGNOSES

Prenatal ultrasound confirmed persistent polyhydramnios and a ruptured amniotic membrane, with no evidence of constriction around the fetal head or body.

INTERVENTIONS

Labor was induced at 39 weeks 6 days using intravenous oxytocin, and a vaginal delivery was performed with an episiotomy-assisted approach due to fetal heart rate decelerations.

OUTCOMES

The infant had Apgar scores of 10 at both 1 and 5 minutes, with normal postnatal growth and development, and the mother recovered well without complications.

LESSONS

Timely prenatal diagnosis and careful monitoring are crucial in managing amniotic rupture.

摘要

理论依据

羊膜带综合征(ABS),即羊膜破裂序列征,是一种罕见的先天性疾病,其特征是纤维性羊膜带可能缠绕胎儿身体部位,导致肢体收缩、畸形,甚至宫内死亡。然而,并非所有羊膜异常都会导致典型的羊膜带综合征。本病例描述了一例晚期羊膜破裂伴有游离羊膜带,但无任何胎儿缠绕或畸形证据。胎儿预后良好,提示这是羊膜破裂的一种良性变异,而非真正的羊膜带综合征。

患者情况

一名30岁初产妇,有羊水过多病史,孕39⁺⁵周时因发现一条漂浮的强回声带就诊,怀疑羊膜破裂及可能的脐带缠绕。

诊断

产前超声证实持续羊水过多及羊膜破裂,未发现胎儿头部或身体有受压迹象。

干预措施

孕39周⁺⁶天时静脉滴注缩宫素引产,因胎儿心率减速,行会阴切开辅助经阴道分娩。

结果

婴儿出生后1分钟和5分钟阿氏评分均为10分,出生后生长发育正常,母亲恢复良好,无并发症。

经验教训

产前及时诊断和仔细监测对于处理羊膜破裂至关重要。

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