Sturgiss S N, Wright C, Davison J M, Robson S C
Department of Obstetrics and Gynaecology, NE1 4LP, U.K.
Prenat Diagn. 1996 Sep;16(9):866-9. doi: 10.1002/(SICI)1097-0223(199609)16:9<866::AID-PD957>3.0.CO;2-X.
Previous reports have suggested that fetal blood sampling from the intrahepatic vein is not associated with significant fetal hepatic injury. We report a case of fetal liver necrosis occurring 24 h following blood sampling from the intrahepatic vein of a fetus with severe growth retardation at 34 weeks. The placenta was in a posterior position, precluding either blood sampling from the placental insertion or placental biopsy. Fetal death occurred in utero within 24 h of the procedure, which was carried out by an experienced operator. At post-mortem the liver appeared normally formed, but the right lobe was diffusely congested, with a well-defined demarcation line between the right and left lobes. Liver histology revealed extensive recent haemorrhagic necrosis of the right lobe.
先前的报告表明,经肝内静脉进行胎儿血样采集与明显的胎儿肝损伤无关。我们报告一例34周严重生长受限胎儿经肝内静脉采血24小时后发生胎儿肝坏死的病例。胎盘位于后壁,无法从胎盘附着处进行血样采集或胎盘活检。该操作由经验丰富的操作人员进行,术后24小时内胎儿死于宫内。尸检时肝脏外观正常,但右叶弥漫性充血,左右叶之间有明确的分界线。肝脏组织学检查显示右叶近期有广泛的出血性坏死。