帆状胎盘并前置血管1例及文献复习

A Case of Velamentous Umbilical Cord Insertion with Vasa Praeviaand Literature Review

摘要: 前置血管是妊娠期较少的产科并发症，指无华通胶或胎盘保护的脐带血管走形于距宫颈内口2 cm范围的胎膜上，位于胎先露或宫颈口内口。当前置血管破裂出血时，常表现为无痛性阴道流血，伴胎心率异常或消失。由于前置血管破裂，常导致胎儿源性出血，新生儿死亡率极高。本文报道1例因无痛性阴道流血就诊的帆状胎盘并前置血管的患者病例，急诊剖宫产终止妊娠后母婴结局良好。并总结了前置血管的高危因素、分型及诊治，以期提高前置血管的检出率，对确诊患者进行系统管理，择期终止妊娠，改善围产儿结局。

Abstract: Vascular previa is a rare obstetric complication during pregnancy. It refers to the umbilical cord blood vessels without the protection of Huatong gel or placenta that are located on the fetal mem-brane within 2 cm of the inner cervical opening, which is located in the fetal exposure or the inner cervical opening. When the anterior vessel is ruptured and bleeding, it often presents as painless vaginal bleeding with abnormal or absent fetal heart rate. Due to the rupture of the prevasculariza-tion, fetal hemorrhage is often caused and the neonatal mortality is very high. This paper reports a case of sailiform placenta with vasoprevia due to painless vaginal bleeding. The outcome was good after emergency caesarean section. And summarizes the high risk factors, types and diagnosis and treatment of blood vessel previa, in order to improve the detection rate of blood vessel previa, sys-tematic management of confirmed patients, elective termination of pregnancy, improve the peri-natal outcome.