射频消融减胎术后并发羊膜带综合征1例
A case of amniotic band syndrome after fetal reduction by radiofrequency ablation
摘要本文报道了1例射频消融减胎术后胎儿并发羊膜带综合征并成功救治的病例。孕妇为自然受孕单绒毛膜双羊膜囊双胎,孕24周产前超声提示双胎输血综合征Ⅲ期,孕妇知情同意选择射频消融减胎术,手术过程顺利。孕28周 +6复查超声提示胎儿左足明显水肿,足踝处可见带状物缠绕,并可见勒痕及缩窄环,多学科会诊考虑羊膜带综合征ⅡB期。当日急诊剖宫产娩一活男婴。新生儿左足踝处可见细羊膜带缠绕数周,勒痕明显,深入皮肤1 cm,足背、足底及足踝下方水肿明显。紧急行左足羊膜带松解术,术后水肿渐消退,随访至28日龄,新生儿下肢恢复正常。
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abstractsThis article reported a survived case of amniotic band syndrome (ABS) following fetal reduction by radiofrequency ablation. The woman conceived monochorionic diamniotic twin pregnancy spontaneously. Prenatal ultrasound at 24 weeks of gestation indicated twin-twin transfusion syndrome (stage Ⅲ), and radiofrequency ablation for fetal reduction was successfully performed after formal consent. At 28 +6 weeks, ultrasound reexamination revealed significant edema in the left foot of the fetus, with banding around the ankle, as well as the strangulation mark and narrowing rings. Fetal ABS (ⅡB stage) was diagnosed after multidisciplinary consultation. An immediate emergency cesarean section was performed and a live male baby was born. A thin amniotic band could be seen wrapping around the left ankle of the newborn for several rounds, with obvious strangulation marks about 1 cm deep into the skin, and significant edema on the dorsum and sole of the foot, and the submalleolus area. The amniotic band was released at once, and the edema faded gradually after surgery. After a follow-up of 28 days, the lower limbs of the newborn became normal.
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