背景:根据产前超声检查,单脐动脉可单独存在或与其他胎儿异常相关。到目前为止,膀胱外翻的确切发病机制尚不清楚。一些学者认为,膀胱外翻和泄殖腔外翻应被视为疾病谱,以探讨其发病机理。如果将膀胱外翻和泄殖腔外翻视为相同的疾病谱,那么我们可以推测单脐动脉应该有同时伴有膀胱外翻的概率。
方法:第一次,我们报道了一例罕见的单脐动脉妊娠胎儿膀胱外翻病例。该患者在怀孕26周时接受了针对性彩色多普勒超声检查,首次怀疑膀胱外翻,单脐动脉和胎儿MRI在怀孕383周时进行诊断,证实了怀疑。确诊后,患者被安排进行多学科讨论.最终,患者选择在怀孕38+5周诱导胎儿死亡,胎儿死亡的身体外观确认了先前的超声和MRI检查结果。
结论:我们的报告是单胎妊娠中首次发现单脐动脉合并膀胱外翻。因此,我们的病例增强了泄殖腔外翻和膀胱外翻应该被视为相同疾病谱的证据。此外,我们对单脐动脉合并膀胱外翻的诊断进展进行了文献综述,希望能为该病的诊断提供有益的参考。
BACKGROUND: According to prenatal ultrasonographic studies, single umbilical artery may be present alone or in association with other fetal abnormalities. So far, the exact pathogenesis of bladder exstrophy is unclear. Some scholars believe that bladder exstrophy and cloacal exstrophy should be regarded as a disease spectrum to explore their pathogenesis. If bladder exstrophy and cloacal exstrophy are regarded as the same disease spectrum, then we can speculate that the single umbilical artery should have the probability of being accompanied by bladder exstrophy at the same time.
METHODS: For the first time, we report a rare
case of fetal bladder exstrophy with single umbilical artery in single pregnancy. This patient underwent targeted color Doppler ultrasound at 26 weeks of pregnancy which first suspected bladder exstrophy with single umbilical artery and fetal MRI for diagnosis at 38 + 3 weeks of pregnancy which confirmed the suspicion. After the diagnosis was confirmed, the patient was scheduled for a multidisciplinary discussion. Ultimately the patient opted for induced fetal demise at 38 + 5 weeks of pregnancy and the physical appearance of the fetal demise affirmed previous ultrasound and MRI examination results.
CONCLUSIONS: Our report is the first finding of single umbilical artery combined with bladder exstrophy in a singleton pregnancy. Accordingly, our
case enhances the evidence that cloacal exstrophy and bladder exstrophy should be treated as the same disease spectrum. In addition, we conducted a literature review on the diagnostic progress of single umbilical artery combined with bladder exstrophy, hoping to provide useful references for the diagnosis of this disease.