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

作　　者：赵晓敏[1] 李雯 申永梅 姚立英[1] 张蕾[1] 李姗姗 田秀英[3] 常颖[1,2] Xiaomin Zhao;Wen Li;Yongmei Shen;Liying Yao;Lei Zhang;Shanshan Li;Xiuying Tian;Ying Chang(Prenatal Diagnosis Center,Tianjin Central Hospital of Obstetrics and Gynecology,Tianjin 300100,China;Tianjin Key Laboratory of Human Development and Reproductive Regulation,Tianjin 300100,China;Department of Neonatology,Tianjin Central Hospital of Obstetrics and Gynecology,Tianjin 300100,China)

机构地区：[1]天津市中心妇产科医院产前诊断中心,天津300100 [2]天津市人类发育与生殖调控重点实验室,天津300100 [3]天津市中心妇产科医院新生儿科,天津300100

出　　处：《中华围产医学杂志》2023年第8期687-690,共4页Chinese Journal of Perinatal Medicine

基　　金：国家临床重点专科专病队列项目(GJZDZKZBDL2022-04)。

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。This 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(stageⅢ),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.

关 键 词：妊娠 双胎 双胎输血综合征 射频消融术 妊娠减少 多胎 羊膜带综合征 

分 类 号：R714.2[医药卫生—妇产科学]