摘要本文报道了1例羊膜带综合征(amniotic band syndrome,ABS)病例.该例孕妇于孕22周+4胎儿系统超声提示未见明显异常,孕30周时,B超发现羊水过多,胎儿水肿可能,收住南京医科大学第一附属医院治疗.入院后予控制血糖,行羊水减量术,B超动态监测羊水指数,每日胎心监护.孕32周起,孕妇出现胎动进行性减少,胎心监护渐呈正弦波样改变;孕32周+3时因胎儿窘迫行急诊剖宫产终止妊娠,术中发现脐带的胎盘插入部见片状羊膜自该处延续至胎儿左下肢近踝部皮肤,羊膜分离呈多孔状,新生儿左踝部可见明显带状缩窄环,左足水肿明显,确诊ABS.该羊膜带对胎儿左足影响较为直接,脐带的胎盘插入部附近的片状羊膜对胎儿是否存在影响尚无足够证据.该早产儿于出生24 h后因“新生儿窒息”死亡.

abstractsA case of amniotic band syndrome (ABS) was reported here.No obvious fetal abnormality was revealed by systematic ultrasound at 22+4 weeks of gestation.At 30 weeks of gestation,the pregnant woman was found to have excessive amniotic fluid and possible fetal edema according to ultrasound images and admitted to the First Affiliated Hospital of Nanjing Medical University.After admission,she received diet control to lower blood glucose and amniotic fluid reduction.The dynamic amniotic fluid index was measured by ultrasound,and the electrical fetal heart rate was monitored daily.Since 32 weeks of gestation,progressive reduction in fetal movement with sinusoidal fetal heart rate pattern was observed.An emergent cesarean section was performed due to fetal distress at a gestational age of 32+3 weeks.During the operation,a porous amniotic membrane was found,from the umbilical cord insertion of the placenta to the ankle of the left lower limb of the fetus.Amniotic band constricting left ankle of newborn and the edema of the left foot was obvious,then ABS was diagnosed.This amniotic band affected the left foot of the fetus directly,while there was not enough evidence whether the flake amniotie membrane near the umbilical cord insertion of the placenta could affect the fetus.This premature infant died of neonatal asphyxia 24 hours after birth.