宫内治疗胎儿胸腔积液合并水肿并发镜像综合征一例

Intrauterine Treatment of Fetal Hydrothorax Combined with Hydrops Complicating Mirror Syndrome:A Case Report

胎儿胸腔积液合并水肿并发镜像综合征是一种极少见的产科病理状态,发病机制尚未明确,症状控制不佳时往往预后不良,甚至危及母儿生命。国内外关于胎儿胸腔积液合并水肿并发镜像综合征报告较少,且无针对该病的临床指南。报道1例胎儿大量胸腔积液合并水肿并发镜像综合征的孕妇,在经过胸腔-羊膜腔分流后,成功延长了孕周,改善了围产儿的预后。通过此病例报道及相关文献复习提高临床医生对胎儿水肿并发镜像综合征的认识,随着镜像综合征的发展,孕妇可能并发子痫前期,临床需高度警惕,可通过宫内治疗改善胎儿水肿情况,适当延长孕周,改善围产儿预后,同时选择到有重症救治能力的医院终止妊娠。

Fetal hydrothorax combined with hydrops complicating mirror syndrome is a rare obstetric pathological condition.Its pathogenesis is not clear at present.The prognosis is often poor when the symptoms are poorly controlled,even endangering both of the mother and child.There are few reports on this condition domestically and internationally,and there is no clinical guidelines for this disease.We report a case of a pregnant woman with massive fetal hydrothorax combined with hydrops complicating mirror syndrome who underwent thoraco-amniotic shunting.This procedure successfully prolonged the gestational week,improving the perinatal prognosis.This case report and the review of related literature can improve clinicians′understanding of fetal hydrops complicated by mirror syndrome.With the development of mirror syndrome,pregnant women may be complicated by preeclampsia,requiring vigilant clinical monitoring.Clinicians can improve the condition of fetal hydrops through intrauterine treatment,appropriately prolong the gestational week,and improve the prognosis of perinatal infants,and at the same time,choose hospitals with the capability of critical care for termination of pregnancy.