双胎胎儿心包内畸胎瘤：诊断与处理
Intrapericardial teratoma in a twin fetus: diagnosis and management.
作者信息
Sklansky M, Greenberg M, Lucas V, Gruslin-Giroux A
机构信息
Department of Pediatrics, University of California, San Diego Medical Center, USA.
出版信息
Obstet Gynecol. 1997 May;89(5 Pt 2):807-9. doi: 10.1016/s0029-7844(97)00031-8.
BACKGROUND
A rare cause of hydrops fetalis, intrapericardial teratoma is invariably associated with a pericardial effusion. In fetal life, the effusion or mass effect may cause cardiac tamponade, hydrops, and death. After delivery, ventilation and cardiac output may be compromised.
CASE
One fetus of twins was diagnosed at 20 weeks' gestation with an intrapericardial teratoma. The affected twin underwent two intrauterine pericardiocentesis and had the tumor resected after delivery at 35 weeks' gestation. One year later, both twins are alive and well and have no evidence of tumor recurrence.
CONCLUSION
Pericardiocentesis for tamponade secondary to a fetal intrapericardial teratoma, even when complicating a twin pregnancy, may prevent fetal death and allow delay of delivery until adequate fetal lung maturity has been achieved.
背景
胎儿水肿的一种罕见病因——心包内畸胎瘤总是与心包积液相关。在胎儿期，积液或肿块效应可能导致心脏压塞、水肿和死亡。分娩后，通气和心输出量可能受到影响。
病例
一对双胞胎中的一个胎儿在孕20周时被诊断为心包内畸胎瘤。受影响的双胞胎接受了两次宫内心包穿刺术，并在孕35周分娩后切除了肿瘤。一年后，两个双胞胎都健康存活，且无肿瘤复发迹象。
结论
对于胎儿心包内畸胎瘤继发的心脏压塞进行心包穿刺术，即使在双胎妊娠合并该情况时，也可能预防胎儿死亡，并允许延迟分娩直至胎儿肺充分成熟。
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