Bart’s水肿胎并发镜影综合征9例临床特征探讨

Bart’s hydrops fetalis complicating mirror syndrome:analysis of 9 cases

目的探讨Bart’s水肿胎并发镜影综合征的临床特征。方法复习镜影综合征相关文献并对广州医学院第三附属医院1999年1月至2008年1月9例Bart’s水肿胎并发镜影综合征病例的临床特点及处理进行分析。结果 9例病例临床特点为发病在妊娠28～34周、不同程度的贫血、水肿、容量依赖性高血压、蛋白尿、低蛋白血症,产后出血发生率高;在临床处理上予以利尿、纠正低蛋白血症及终止妊娠后病情迅速缓解。结论 Bart’s水肿胎并发镜影综合征的孕妇临床显著特点为早发型子痫前期、贫血及低蛋白血症,处理的重点为终止妊娠、预防产后出血和纠正低蛋白血症,提示在处理此类患者时应高度重视此类特殊类型子痫前期所表现的临床异质性及临床可预防性。

Objective To discuss the clinical features of Bart＇s hydrops fetalis complicating Mirror Syndrome. Methods The references about Mirror Syndrome were reviewed and the clinic data of 9 cases Bart＇s hydrops fetalis complicating Mirror Syndrome in the Third Affiliated Hospital of Guangzhou Medical College between Jan. 1999 and Jan. 2008 were collected to aoalyze the clinical features. Results All the eases were diagnosed at 28 to 34 weeks gestation, the clinical features appeared as anemia, severe edema, hypertension, high blood volume, hypoalbuminemia and high incidence of postpartum hemorrhage. The main managements were to diuresis, correct hypoalbuminemia and the symptoms were rapidly recovered after delivery. Conclusion The predominant clinical features of the Mirror Syndrome women with Bart＇s hydrops fetalis are early pre-eelampsia, anemia, hypoalbuminemia. The important managements are to diuresis, correct hypoalbuminemia and prevent postpartum hemorrhage. Our results suggest that obstetricians should pay special attention to heterogeneus clinical features between Mirror Syndrome and pre-eclampsia in obstetric management, and prevent Barf＇s hydrops fetalis complicating Mirror Syndrome by prenatal diagnosis in the first and second trimester.