调皮的胎儿:竟将腿脚伸出了子宫

2017-01-07 haitao1230 妇产时间

近日,新英格兰杂志发布的一幅图片让医学界很是震惊,很多社交网络及报社进行报道。图片为一孕妇的腹部 MRI 检查图片,其内可见一胎儿将双侧腿脚伸出了子宫,但羊膜并未破裂,因为压力的缘故羊水大多透过破裂的子宫壁流向腿脚的一侧,形成一巨大的「囊肿」。像极了一个调皮的胎儿用双脚踢破子宫,并将腿脚伸出。图 1 孕妇的胎儿 MRI 检查图,图片显示左侧子宫壁破裂,形成 2.5 cm 的疝口(箭头所示)

近日,新英格兰杂志发布的一幅图片让医学界很是震惊,很多社交网络及报社进行报道。图片为一孕妇的腹部 MRI 检查图片,其内可见一胎儿将双侧腿脚伸出了子宫,但羊膜并未破裂,因为压力的缘故羊水大多透过破裂的子宫壁流向腿脚的一侧,形成一巨大的「囊肿」。像极了一个调皮的胎儿用双脚踢破子宫,并将腿脚伸出。

图 1 孕妇的胎儿 MRI 检查图,图片显示左侧子宫壁破裂,形成 2.5 cm 的疝口(箭头所示)。子宫内羊水及胎儿腿脚疝出,所示羊膜并未破裂

文章中指出,该产妇为 32 岁,曾有 5 次剖宫产史。产妇并未出现任何临床症状,在 22 周超声检查时发现异常后行 MRI 检查进一步确认。

根据华盛顿邮报的报道,该事件发生在法国的 Angers 大学医学中心,首诊医生 Pierre-Emmanuel Bouet 发现该孕妇的异常表现时非常吃惊。在其接受采访的邮件中说当首次发现自己的病人羊膜疝出子宫时很难相信,第一反应就是找来自己的同事确认自己的诊断。

该医学中心的医生告知了患者潜在的危险性,并建议孕妇终止妊娠。但孕妇最终选择在严密观察下继续妊娠。30 周超声检查时提示子宫破裂口增大到 5 cm,行剖宫产手术,婴儿为男孩,1385 g,母子平安。在随后 6 个月随访中孩子体健,发育完好。

像类似的事件在医学史上极为少见,孕妇子宫破裂处正是之前多次剖宫产留下的疤痕处。多次手术疤痕处子宫壁变硬,韧性减低,很难承受最后一次妊娠导致的子宫扩大的牵拉力而导致撕裂。因此,我们不能怪罪这个无辜胎儿了的调皮了。

子宫撕裂按照常理来说,孕妇应该会感到疼痛,但多次的剖宫产疤痕神经末梢的减少,让该孕妇未发生任何临床症状。撕裂的子宫壁也恰好让疝囊和胎儿的腿脚压住,并未出现内部出血情况。这样说来倒是应该感谢这个调皮的胎儿了。在随后的 8 周的密切观察下,母子平安度过此劫,算是最完美的结局了。

原始出处:

1, http://www.nejm.org/doi/pdf/10.1056/NEJMicm1603843

2, https://www.washingtonpost.com/news/morning-mix/wp/2016/12/23/i-was-astonished-french-doctor-discovers-babys-legs-protruding-from-mothers-womb/?hpid = hp_rhp-morning-mix_mm-baby%3Ahomepage%2Fstory&utm_term =.01cafa91388b

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    2017-02-18 1e216e61m01(暂无匿称)

    神奇

    0

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    2017-01-18 ys2323

    第一次听说。

    0

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    2017-01-09 1e1dfcb1m40(暂无匿称)

    多次剖宫产对以后的生育有很大危险

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=176877, encodeId=2aa51e68770e, content=神奇, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170218/IMG58A7E17D25CFF3300.jpg, createdBy=57b22022652, createdName=1e216e61m01(暂无匿称), createdTime=Sat Feb 18 22:12:14 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171027, encodeId=97761e102793, content=第一次听说。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160616/IMG5762A3665DC7B3997.jpg, createdBy=df0a1649089, createdName=ys2323, createdTime=Wed Jan 18 06:48:13 CST 2017, time=2017-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=168995, encodeId=332a16899598, content=多次剖宫产对以后的生育有很大危险, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d3992007234, createdName=1e1dfcb1m40(暂无匿称), createdTime=Mon Jan 09 08:21:18 CST 2017, time=2017-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=168884, encodeId=d44d168884cd, content=看过了~~分享……, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eeef1960262, createdName=杨柳青青, createdTime=Sun Jan 08 20:39:17 CST 2017, time=2017-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=168784, encodeId=166b168e84d0, content=有意思好东西!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sun Jan 08 09:26:48 CST 2017, time=2017-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=168735, encodeId=7d54168e353a, content=生命太神奇了, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuNib2ibCzAHhv9SZIn8nWA2GibA5kvJsTzl1vx602Pp56JWgq4pqfAGEwqqmRn9bMdCK52CU1XlN5Xx/0, createdBy=877b1684446, createdName=人生如书, createdTime=Sun Jan 08 07:43:54 CST 2017, time=2017-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=168712, encodeId=c83f168e1209, content=好厉害的宝宝, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5Rzegz2kicwSDGST4gkzMm8229KtEaV7JEushLtsOJ4OweeyQ7oiaqU73G1eVialdQSZrH7DWxTgR8pYZ/0, createdBy=e81f1959878, createdName=小大夫快跑, createdTime=Sun Jan 08 06:18:58 CST 2017, time=2017-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=168703, encodeId=403e168e03c9, content=子宫壁这么薄, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cb571956164, createdName=187清风, createdTime=Sun Jan 08 01:18:50 CST 2017, time=2017-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=168684, encodeId=8b4b1686847a, content=哇真是神奇, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/nVMLr1AgPVPqCvgGl1CbPiaOLBkYK6c3zXpECMkZ0VzfbnYGFnWQ9xOly0XibiceTVGKdMJVAbX2TEz9Yt6uxvvJQ/0, createdBy=a8411981495, createdName=1e183db5m33(暂无匿称), createdTime=Sat Jan 07 22:39:34 CST 2017, time=2017-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=168667, encodeId=d02216866e3a, content=第一次见这么惊险刺激的胎儿,幸好胎儿发育没受影响, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Jan 07 21:28:48 CST 2017, time=2017-01-07, status=1, ipAttribution=)]
    2017-01-08 杨柳青青

    看过了~~分享……

    0

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    2017-01-08 thlabcde

    有意思好东西!

    0

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    2017-01-08 人生如书

    生命太神奇了

    0

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    2017-01-08 小大夫快跑

    好厉害的宝宝

    0

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    2017-01-08 187清风

    子宫壁这么薄

    0

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    2017-01-07 1e183db5m33(暂无匿称)

    哇真是神奇

    0

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    2017-01-07 有备才能无患

    第一次见这么惊险刺激的胎儿,幸好胎儿发育没受影响

    0

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