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本文报告2例双角子宫合并妊娠妇女在产前绒毛取样后胎儿死亡。作者连续2800次绒毛取样检查中,有14例在操作后2周内发生胎儿死亡,其中2例术前超声检查曾确定患有双角子宫,1例经宫颈取绒毛后72小时内有少量出血和腹痛,取样后8天超声检查胎儿存活,取样后10天诊断有宫内感染,尽管孕妇病情轻但胎儿死亡;另1例双角子宫患者经腹取绒毛,术后无症状,而取样后7天超声确定胎儿死亡。此2例滋养细胞核型均正常。此后,又有1例双角子宫妇女要求绒毛取样检查,告知绒毛取样有增大胎儿死亡之可能性,乃于孕16周时行羊膜腔穿刺。在穿刺24小时内发生大量羊水液漏出,11天后胎儿死亡。作者的3500次在实时超声指导下进行的羊膜腔穿刺中,仅有4例胎儿在取标本后2周内死亡。
This article reports fetal death in 2 cases of double-angle uterus with pregnancy in prenatal villus sampling. Of the 2,800 consecutive villi sampling examinations, 14 had fetal deaths within 2 weeks of surgery, 2 of whom had a preoperative sonogram that had been diagnosed with a double angle uterus and 1 had a small amount of bleeding within 72 hours of cervical villus retrieval And abdominal pain. The fetus survived 8 days after the sampling. The intrauterine infection was diagnosed 10 days after the sample was taken, although the pregnant woman was in mild condition and died of fetal death. The other 1 case of double angle uterus was abdominally deprived of villus and postoperative asymptomatic, but after sampling 7 days ultrasound to determine fetal death. The two cases of trophoblastic karyotypes were normal. Since then, another case of women with dual uterine cervix asked for sampling of villus to inform the possibility of villi sampling to increase fetal death, but at 16 weeks of pregnancy amniocentesis. A large number of amniotic fluid leakage occurred within 24 hours of puncturing and the fetus died after 11 days. Of the 3,500 injections of amniocentesis under real-time ultrasound guidance, only 4 fetuses died within 2 weeks of taking the specimen.