发育医学电子杂志  2022, Vol. 10 Issue (1): 55-57 DOI: 10.3969/j.issn.2095-5340.2022.01.010 |
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围产医学
病例报告
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| 胎儿部分脐- 体静脉分流病例1 例 |
| 冼诗瑶 梁雪梅 黄泳华 冯穗华 |
广东省江门市中心医院 产科，广东 江门 529000
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| Fetal partial umbilical-systemic venous shunt: a case report |
| Xian Shiyao, Liang Xuemei, Huang Yonghua, et al |
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摘要 孕妇，34岁，G2P1，2016年足月剖宫产1女婴，现体健。本次自然受孕，孕13+周行胎儿颈项透明层（nuchal translucency, NT）超声检查提示：NT增厚（4.6 mm），静脉导管a波倒置。于孕16+周行羊膜腔穿刺，羊水染色体核型及染色体微阵列未见异常。孕24+周行三维超声检查提示：胎儿心胸比例增大（0.65），羊水过多［羊水最大深度（amnioticfluid volume, AFV ）: 80 mm，羊水指数（amniotic
fluid index, AFI）：260 mm］。胎儿超声心动图检查提示：胎儿左心房、左心室、右心房增大，心胸比例增大，卵圆孔增大，心包少量积液，其余心内结构未见明显异常声像；体外脐静脉宽约11.2 mm，脐静脉入腹腔后分成上下两支静脉，其一支静脉向上进入肝脏（管径约4.5 mm，其流速约24 cm/s），再经静脉导管进入右心房，肝内脐静脉门静脉系统显示走行正常；另一支异常静脉向下进入盆腔（与脐动脉伴行，其管径约6.4 mm，流速约40 cm/s），隐约见其再分为左右支后连入髂静脉。静脉导管内径约2.2-2.7mm，长约13.2 mm，考虑部分脐体静脉吻合畸形，静脉导管稍粗长。经多学科讨论后，孕妇及家属要求保留胎儿，遂定期复查胎儿Ⅱ级超声及胎儿超声心动图检查.
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| 关键词:
NT增厚
胎儿脐-体静脉分流
静脉导管发育不良
胎儿水肿
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收稿日期: 2020-01-13
发布日期: 2022-01-28
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| 基金资助: 江门市医疗卫生技术计划项目（2021020300900002129） |
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通讯作者:
冼诗瑶
E-mail: Email：hhssccooaa@163.com
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