摘要
目的探讨产科镜像综合征的临床特点及处理、妊娠结局及预后。方法收集2008年4月—2010年12月深圳市妇幼保健院收治的12例产科镜像综合征患者的临床资料，对其临床特点及处理、妊娠结局进行回顾性分析。结果（1）发病原因：12例产科镜像综合征患者中9例胎儿为Ban水肿胎儿，2例胎儿为先天性心脏病，1例胎儿水肿原因不明。（2）诊断孕周及终止妊娠孕周：12例患者的诊断孕周为28～36周，平均（31．5±4．7）周，终止妊娠孕周为28周^＋3～38周，平均为（32．9±2．9）周。符合重度子痫前期诊断标准的产科镜像综合征诊断孕周为（31．8±2．3）周，终止妊娠孕周为（32．5±2．3）周；符合轻度子痫前期诊断标准的产科镜像综合征诊断孕周为（30．9±7．2）周，终止妊娠孕周为（33．5±3．9）周，两者诊断孕周和终止妊娠孕周比较，差异均无统计学意义（P〉0．05）。（3）产科镜像综合征患者具有子痫前期疾病样的临床表现：12例患者中，伴肢体水肿12例，头痛及视物模糊1例，尿蛋白定性阳性11例，高血压5例，尿酸水平升高9例，低蛋白血症12例，肌酐水平升高3例，肝酶水平升高1例，血小板计数减少2例；常见并发症有HELLP综合征、急性肺水肿、胎盘早剥、羊水栓塞、DIC各1例，急性肾功能不全3例，产后出血6例。（4）超声检查特点：①胎儿水肿：12例患者超声检查均发现胎儿的胸腔、腹腔、皮肤、头皮水肿，同时有脑室增宽，心包积液和心胸比增大。②胎盘增厚：病理检查均提示胎盘绒毛不同程度水肿。12例患者的胎盘厚度均〉4cm，平均（6．3±1.9）cm。③羊水过多：12例患者中11例羊水过多，平均羊水指数（19．7±3．1）cm。（5）产后情况：产后5—7d12例患者血压均恢复正常，尿蛋白定性阴性，实验室检查结果均恢复正常。（6）妊娠结局：12例患
Objective To discuss the prognosis of obstetric mirror syndrome. Methods clinical features, management, pregnancy outcome and The clinical data of 12 cases with obstetric mirror syndrome at Shenzhen Maternity and Child Healthcare Hospital from April 2008 to December 2010 were collected to retrospectively analyze the clinical features, management, pregnancy outcome and prognosis. Results （ 1 ） Etiology ： 12 cases with obstetric mirror syndrome included 9 cases of Bart＇s hydrops fetalis, 2 cases with fetal complicated congenital cardiac anomalies, and 1 case of unknown etiology. （2） Gestational age at diagnosis and at delivery：gestational age at diagnosis ranged from 28 to 36 weeks [ mean （31.5 ± 4. 7 ） weeks ], and gestational age at delivery ranged from 28 ＋3 to 38 weeks [ mean （32. 9 ± 2. 9 ） weeks]. There were no significant differences between the gestational age at diagnosis and at delivery in consistented with severe preeclampsia group and mild preeclampsia group [ （31.8 ± 2. 3 ） weeks vs. （30.9±7.2） weeks, （32.5±2.3） weeks vs. （33.5±3.9） weeks, P〉0.05 ]. （3） The patients with obstetric mirror syndrome can present a preeelampsia-like syndrome：maternal extremity edema in 12 cases, headache and visual disturbance in 1 case, proteinuria in 11 cases, elevated blood pressure in 5 cases, elevated uric acid in 9 cases, hypoproteinemia in 12 cases, elevated creatinine in 3 case, elevated liver enzyme in 1 case, thrombocytopenia in 2 cases. The major complications included 1 case of HELLP syndrome, acute pulmonary edema, placental abruption, amnionie fluid embolism, DIC respectively, 3 eases of acute kidney failure and 6 eases of postpartum hemorrhage. （4） Sonographie findings：（1） Hydrops fetalis：fetal ultrasound revealed pleural fluid, fetal aseites, skin edema, scalp edema, encephalocolele enlargement, hydropericardium and increased eardio-chest ratio. （2） Placenta megaly： the placental pathological examination revealed edematous and large in
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2012年第3期175-178,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
胎盘功能不全
水肿
胎儿
先兆子痫
妊娠结局
Placental insufficiency
Hydrops fetalis
Pre-eclampsia
Pregnancy outcome
