foetal

胎儿
  • 文章类型: Case Reports
    近年来,胃裂病有所增加,然而,复杂的腹裂与较高的死亡率有关,以及短期和长期并发症导致的更高的医疗保健成本和疾病负担。
    一名25岁的女性在妊娠37+1周(第2次妊娠;第0次妊娠)时,因胎儿胃裂入院。在我院进行的靶向四元超声检查显示,腹壁连续中断34mm,观察到范围约为88×50毫米的肠回声向外凸出,靠近肠壁的局部区域显示出34×23米的回声,胎儿比预期小2周。在包括母婴医学在内的MDT之后,超声,儿科手术,新生儿重症监护病房(NICU),和麻醉科,剖腹产在37+2周。生了一个男婴,小肠,腹部外可见大肠和胃,从脐带右侧的缺损中排除了腹腔,肠系膜缩短了,经儿科手术讨论,肠管有明显的水肿,进行筒仓袋放置和延迟关闭,放置过程很顺利。竖井放置一周后,每天内脏部分减少后,腹部内容物已经完全减少到筋膜以下,第二阶段的手术是在全身麻醉下进行的。新生儿在手术后20天顺利出院,并进行了随访,随着良好的增长,正常的牛奶摄入量和平稳的排便。
    复杂胃裂的诊断和治疗需要在多学科小组治疗下进行。37周后剖宫产分娩是可行的。立即进行产后手术是可能的,手术方式的选择取决于孩子的病情,强调在麻醉下应在没有足够镇静的情况下进行。应制定适合风险的标准化术后护理路径,以优化营养支持和抗生素使用。应寻求长期随访的标准化肠内喂养方法。
    UNASSIGNED: Gastroschisis has increased in recent years, however, complicated gastroschisis is associated with higher mortality, as well as higher health care costs and disease burdens from short- and long-term complications.
    UNASSIGNED: A woman aged 25 years old at 37 + 1 weeks gestation (gravida 2; para 0) was admitted to the hospital because of foetal gastroschisis. Targeted quaternary ultrasound performed at our hospital showed that 34 mm of the abdominal wall was interrupted continuously, an intestinal echo with a range of approximately 88 × 50 mm was seen bulging outwards the local area close to the intestinal wall showed a 34 × 23 m anecho, and the foetus was measuring 2 weeks smaller than expected. After MDT including the maternal-foetal medicine, ultrasound, paediatric surgery, neonatal intensive care unit (NICU), and anaesthesiology departments, caesarean section was performed at 37 + 2 weeks. A baby boy was delivered, the small intestine, large intestine and stomach were seen outside of the abdomen, the abdominal cavity was excluded from the defect on the right side of the umbilical cord, the mesentery was shortened, and the intestinal tube had obvious oedema After paediatric surgical discussion, silo bag placement and delayed closure was performed, the placement process was smooth. One week following silo placement, the abdominal contents had been fully reduced below the fascia following daily partial reductions of the viscera,and the second stage of the operation was performed under general anaesthesia. The newborn was successfully discharged from the hospital 20 days after the operation and was followed up, with good growth, normal milk intake and smooth bowel movements.
    UNASSIGNED: The diagnosis and treatment of complicated gastroschisis needs to be carried out under multidisciplinary team treatment. Delivery by cesarean section after 37 weeks is feasible.Immediate postpartum surgery is possible, and the choice of surgical modality is determined by the child\'s condition, emphasizing that it should be performed without adequate sedation under anaesthesia. A standardized postoperative care pathway appropriate to risk should be developed to optimize nutritional support and antibiotic use, and standardized enteral feeding practices should be sought with long-term follow-up.
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  • 文章类型: Case Reports
    在复杂的胎儿心脏畸形中可以发现胎儿动脉导管(DA)收缩,但很少作为一个孤立的缺陷。尽管许多DA收缩病例通常与非甾体抗炎药(NSAIDs)母体摄入有关,其他原因仍然没有确定的病因,被称为特发性。最近,广泛的风险因素或物质(富含多酚的食物摄入量,萘甲唑啉,氟西汀,咖啡因和杀虫剂)对炎症途径有明确的影响,导致DA收缩。我们报告了一例女性过早发生DA收缩的情况,该女性的母亲职业暴露于溶剂中,可能的危险因素被确定,并对176例与NSAID无关的DA收缩进行了全面的文献综述。一名30岁的亚洲妇女因怀疑过早的DA收缩而在33孕周零0天时被转诊到我们的机构。这名妇女没有服药史,包括NSAIDs,酒精,怀孕期间食用烟草或富含多酚的食物。详细的胎儿超声心动图显示正常的心脏解剖与肥大,运动减退和右心室扩张由于右压力超负荷,全收缩期三尖瓣反流,and,在DA的层面上,高收缩和舒张速度,指示过早的导管限制。右流出显示肺动脉扩张,DA狭窄。由于DAPI恶化和右侧压力超负荷的迹象,在妊娠33周和4天时进行了紧急剖腹产,尽管中断接触溶剂。我们假设过早的DA收缩与母体职业暴露于溶剂之间存在关系。在患者的两个孩子中,相关胎儿畸形的存在加强了这一假设。需要进一步的研究来证实暴露于溶剂和有毒化学物质在DA收缩的发病机理中的作用。还有实验动物模型。关键信息许多DA收缩病例通常与非甾体抗炎药(NSAIDs)的母体摄入有关。广泛的风险因素或物质(富含多酚的食物摄入量,萘甲唑啉,氟西汀,咖啡因和杀虫剂)会导致胎儿DA收缩。需要进一步研究以确认母体暴露于溶剂在DA收缩的发病机理中的作用。
    Foetal ductus arteriosus (DA) constriction can be found in complex foetal heart malformations, but rarely as an isolated defect. Although many cases of DA constriction are usually related to Non-steroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake, other causes remain without an established aetiology and are referred to as idiopathic. Recently, a wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) showed a definitive effect upon the pathway of inflammation, causing DA constriction. We report a case of a premature DA constriction in a woman whose possible risk factor was identified in her maternal occupational exposure to solvents and a comprehensive literature review of 176 cases of NSAID-unrelated DA constriction. A 30-year-old Asian woman was referred to our institution at 33 gestational weeks and 0 days because of suspicion of premature DA constriction. The woman had no history of medication intake, including NSAIDs, alcohol, tobacco or polyphenol-rich-food consumption during pregnancy. A detailed foetal echocardiography revealed a normal cardiac anatomy with hypertrophic, hypokinetic and a dilated right ventricle due to right pressure overload, holosystolic tricuspid regurgitation, and, at the level of the DA, high systolic and diastolic velocities, indicating premature ductal restriction. The right outflow showed dilatation of the pulmonary artery with narrow DA. An urgent caesarean section was performed at 33 gestational weeks and 4 days due to worsening of DA PI and signs of right pressure overload, despite the interruption of exposure to solvents. We assume a relationship exists between premature DA constriction and a maternal occupational exposure to solvents. This hypothesis is reinforced by the presence of associated foetal malformations in in two of the patient\'s children. Further research is needed to confirm the role of exposure to solvents and toxic chemicals in the pathogenesis of DA constriction, also with experimental animal models.KEY MESSAGESMany cases of DA constriction are usually related to Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake.A wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) can cause foetal DA constriction.Further investigation are needed to confirm the role of maternal exposure to solvents in the pathogenesis of DA constriction.
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  • 文章类型: Case Reports
    背景:先天性眼眶畸胎瘤相对罕见,在这种情况下,很少有关于产前超声检查结果的报道。
    方法:1例罕见的先天性眼眶畸胎瘤在妊娠24+2周时被诊断为小眼症,注意没有眼球突出的眼眶畸胎瘤与小眼症的区别,视网膜母细胞瘤和颅内畸胎瘤。超声检查,大体标本分析,组织病理学评估证实了眶畸胎瘤的诊断。
    结论:产前超声检查可用于先天性眼眶畸胎瘤的诊断和鉴别诊断。
    BACKGROUND: Congenital orbital teratoma is relatively rare, and few reports of prenatal ultrasound findings in such cases have been published.
    METHODS: A rare case of congenital orbital teratoma at 24 + 2 weeks of gestation was previously diagnosed as microphthalmia, noting how orbital teratoma without proptosis is different from microphthalmia, retinoblastoma and intracranial teratoma. Ultrasound examination, analysis of gross specimens, and histopathological evaluation confirmed the diagnosis of orbital teratoma.
    CONCLUSIONS: Prenatal ultrasound examination is useful for diagnosis and differential diagnosis of congenital orbital teratoma.
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  • 文章类型: Journal Article
    全局,产时死产每年造成100万婴儿死亡,约占全球死产人数的三分之一。产时死产的原因包括产妇医疗和产科条件;怀孕期间获得优质产科护理服务;和类型,产时护理的时间和质量。不同的医疗条件,包括高血压和代谢紊乱,怀孕期间的感染和营养缺乏是死产的危险因素。埃塞俄比亚仍然是10个高负担死产国家之一,估计每1000例新生儿中有25例以上。
    进行了一项病例对照研究,该研究使用了2010年7月1日至2015年6月30日期间在亚的斯亚贝巴的23个公共卫生机构中发生产时死产的妇女病历的图表审查的主要数据。数据是从符合纳入标准的所有产时死胎病例的图表中收集的,并以2比1(2:1)的对照与病例比例随机选择的对照图表。
    慢性疾病,包括糖尿病,在研究人群中,心脏和肾脏疾病的患病率较低(1%),而在综述中,仅有6%的女性在妊娠期出现高血压疾病.此外,6.5%的研究人群患有HIV感染,其中HIV阴性可以预防产时死产(aOR0.37,95%CI0.18-0.78)。在上次ANC访视期间出现非头胎儿表现的妇女发生产时死产的风险是后者的三倍,而单胎妊娠对产时死产具有很强的保护性关联(p<0.05)。
    未经治疗的慢性疾病,感染,胎儿状况监测不良和多胎妊娠是产时死胎的重要危险因素.
    UNASSIGNED: globally, intrapartum stillbirth accounts for 1 million deaths of babies annually, representing approximately one-third of global stillbirth toll. Intrapartum stillbirth occurs due to causes ranging from maternal medical and obstetric conditions; access to quality obstetric care services during pregnancy; and types, timing and quality of intrapartum care. Different medical conditions including hypertensive & metabolic disorders, infections and nutritional deficiencies during pregnancy are among risk factors of stillbirth. Ethiopia remains one of the 10 high-burden stillbirth countries with estimated rate of more than 25 per 1000 births.
    UNASSIGNED: a case-control study using primary data from chart review of medical records of women who experienced intrapartum stillbirth in 23 public health facilities of Addis Ababa during the period July 1, 2010 - June 30, 2015 was conducted. Data was collected from charts of all cases of intrapartum stillbirth meeting the inclusion criteria and randomly selected charts of controls in two to one (2:1) control to case ratio.
    UNASSIGNED: chronic medical conditions including diabetes, cardiac and renal diseases were less prevalent (1%) among the study population whereas only 6% of women experienced hypertensive disorder during the pregnancy in review. Moreover, 6.5% of the study population had HIV infection where being HIV negative was protective against intrapartum stillbirth (aOR 0.37, 95% CI 0.18-0.78). Women with non-cephalic foetal presentation during last ANC visit were three times more at risk of experiencing intrapartum stillbirth whereas singleton pregnancy had strong protective association against intrapartum stillbirth (p<0.05).
    UNASSIGNED: untreated chronic medical conditions, infection, poor monitoring of foetal conditions and multiple pregnancy are among important risk factors for intrapartum stillbirth.
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  • 文章类型: Case Reports
    Misoprostol is a well known abortifacient. It can cause teratogenicity like Mobius sequence and terminal transverse limb defects. We report a rare case of proximal focal femoral deficiency with fibular hemimelia in a woman who had attempted abortion with self-administered misoprostol and later continued the pregnancy. Though the absolute risk of congenital malformations with its use is low ∼1%, this should be clearly communicated to the women requesting abortion to help them make fully informed reproductive health decisions.
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