妊娠合并脐尿管瘘1例  

Pregnancy complicated by patent urachus:A case report

作　　者：杨俊娟 张蕾[1] 张龑[1] YANG Junjuan;ZHANG Lei;ZHANG Yan(Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院妇产科,北京100191 [2]河南省郑州市妇幼保健院

出　　处：《北京大学学报(医学版)》2025年第2期393-395,共3页Journal of Peking University:Health Sciences

摘　　要：脐尿管瘘是指胎儿期脐尿管完全不闭合,出生后脐与膀胱仍相通,一定条件下尿液可自脐部漏出。该病临床少见,多在新生儿期发病,成人发病率约1/5000[1-2],男性多于女性,孕晚期发现者极为罕见。现报道1例孕晚期发现脐尿管瘘患者的临床资料,并结合文献讨论该病的妊娠期诊治方法。To improve clinicians’understanding,and to explore the diagnosis and treatment of pregnancy complicated with patent urachus.The clinical symptoms,ultrasound images,and delivery outcome of the pregnancy complicated with patent urachus were reported,and the literature was reviewed.The patient had umbilical leakage as a young child occasionally,the symptom of leakage was not obvious after she was 10 years old,and there was no asymptomatic before pregnancy and in the first and second trimesters.Umbilical leakage was present at gestational 33 weeks,and ultrasound showned a tubular structure(0.7 cm in width)was connected between the top of the bladder and the umbilicus,and there was anechoic areas inside.The pregnancy complicated with patent urachus was diagnosed.The patient was checked regularly,and kept the umbilicus clean and dry.Premature rupture of membranes occured at gestational 39 weeks 4 days.The patient was admitted to the obstetrics department,and she deliveried finally.After delivery,the symptoms of umbilical leakage urine relieved,and an elective resection of abnormal urachus was planned.The patent urachus creates a tube connection between the umbilicus and the anterosuperior wall of the bladder,it was termed an median umbilical ligament at birth as usual,which still communicated with the bladder after birth.The main clinical manifestations were umbilical leak and infection,which were the main diagnostic basis.Ultrasound,CT and MRI were important auxi-liary examination methods.The patients with symptoms in the neonatal and early childhood period were managed actively and had the potential for self resolution,especially for the children younger than 1 year.Therefore,patients under 1 year of age were offered surgery only if they had recurrent infections or failed to selfresolve.It is recommended to remove abnormal urachus before pregnancy for the women complica-ted with patent urachus.If the patent urachus was found during pregnancy,the umbilicus should be kept clean and dry to avoid infection.The pregnanc

关 键 词：妊娠 脐尿管瘘 脐尿管解剖 

分 类 号：R714.2[医药卫生—妇产科学]