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自1758年Burdach首次报道脐带缩窄伴扭转的第一例病例以来,文献报道共有50例,均胎死宫内,于产后作出诊断。本又报道3例脐带缩窄致胎死宫内的病例。 例1,36岁,G_1P_0,高龄孕妇。于孕16周B超显示胎儿形态正常与孕周相符,在超声引导下行羊膜腔穿刺,抽出30ml清羊水,穿刺后发现胎儿心动过缓,几小时后胎死宫内。胎儿娩出后检查发现在胎儿脐根部1cm处脐带显著狭窄伴扭转,核型分析为正常女性46,XX。病理检查发现针穿刺点在胎盘上,脐带未受累,脐带胎盘无血肿,脐带长18.5cm 直径平均0.7cm。离脐根部3.4cm处有一长1cm、直径仅0.2cm的脐带缩窄伴扭转,在缩窄处可见三条通畅的血管,
Since the first case of umbilical cord constriction with torsion reported by Burdach in 1758, a total of 50 cases have been reported in the literature and were diagnosed in postpartum. This also reported 3 cases of umbilical cord narrowing caused by intrauterine fetal cases. Cases of 1,36 years old, G_1P_0, elderly pregnant women. At 16 weeks of pregnancy, B-mode ultrasound showed normal fetus morphology consistent with gestational age. Ultrasound-guided amniocentesis was performed. 30ml of amniotic fluid was removed and the fetus was found to have bradycardia after puncturing. After a few hours, the fetus died of intrauterine growth. After the fetus was delivered, it was found that the umbilical cord was stenosed and twisted at 1 cm at the root of the umbilical cord. The karyotype analysis was normal for women 46 and XX. Pathological examination found that the needle puncture point in the placenta, umbilical cord is not involved, umbilical cord placental hematoma, umbilical cord length 18.5cm average 0.7cm in diameter. 3.4cm away from the root of umbilical there is a long 1cm, 0.2cm in diameter umbilical cord narrowed with torsion, visible in the narrow three smooth blood vessels,