[Pregnancy complicated by patent urachus: A case report].

Q3 Medicine
北京大学学报(医学版) Pub Date : 2025-04-18
Junjuan Yang, Lei Zhang, Yan Zhang
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引用次数: 0

Abstract

To improve clinicians' understanding, and to explore the diagnosis and treatment of pregnancy complicated with patent urachus. The clinical symptoms, ultrasound images, and delivery outcome of the pregnancy complicated with patent urachus were reported, and the literature was reviewed. The patient had umbilical leakage as a young child occasionally, the symptom of leakage was not obvious after she was 10 years old, and there was no asymptomatic before pregnancy and in the first and second trimesters. Umbilical leakage was present at gestational 33 weeks, and ultrasound showned a tubular structure (0.7 cm in width) was connected between the top of the bladder and the umbilicus, and there was anechoic areas inside. The pregnancy complicated with patent urachus was diagnosed. The patient was checked regularly, and kept the umbilicus clean and dry. Premature rupture of membranes occured at gestational 39 weeks 4 days. The patient was admitted to the obstetrics department, and she deliveried finally. After delivery, the symptoms of umbilical leakage urine relieved, and an elective resection of abnormal urachus was planned. The patent urachus creates a tube connection between the umbilicus and the anterosuperior wall of the bladder, it was termed an median umbilical ligament at birth as usual, which still communicated with the bladder after birth. The main clinical manifestations were umbilical leak and infection, which were the main diagnostic basis. Ultrasound, CT and MRI were important auxi-liary examination methods.The patients with symptoms in the neonatal and early childhood period were managed actively and had the potential for self resolution, especially for the children younger than 1 year. Therefore, patients under 1 year of age were offered surgery only if they had recurrent infections or failed to selfresolve. It is recommended to remove abnormal urachus before pregnancy for the women complica-ted with patent urachus. If the patent urachus was found during pregnancy, the umbilicus should be kept clean and dry to avoid infection. The pregnancy complicated with patient urachus is not contraindicated to vaginal delivery.

妊娠合并输卵管未闭1例。
目的提高临床医师对妊娠合并尿管未闭的认识,探讨妊娠合并尿管未闭的诊断和治疗方法。本文报道妊娠合并尿管未闭的临床症状、超声图像及分娩结局,并复习相关文献。患者幼时偶有脐漏,10岁后症状不明显,孕前及孕早期、中期无无症状。孕33周出现脐漏,超声示膀胱顶部与脐部连接管状结构(宽0.7 cm),内可见无回声区。诊断为妊娠合并输卵管未闭。定期对患者进行检查,保持脐部清洁干燥。胎膜早破发生在妊娠39周4天。病人被送进了产科,她终于分娩了。分娩后,脐漏尿症状缓解,并计划择期切除异常尿管。尿管未闭在脐部和膀胱前上壁之间形成一个管状连接,出生时通常称为脐正中韧带,出生后仍与膀胱相通。主要临床表现为脐漏和感染,是诊断的主要依据。超声、CT、MRI是重要的辅助检查方法。在新生儿和幼儿期出现症状的患者得到积极的管理,并有自我解决的潜力,特别是对1岁以下的儿童。因此,1岁以下的患者只有在反复感染或无法自我解决的情况下才进行手术。对于合并尿管未闭的妇女,建议在妊娠前切除异常尿管。妊娠期间如发现脐未闭,应保持脐部清洁干燥,避免感染。妊娠合并泌尿道患者不禁忌阴道分娩。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
北京大学学报(医学版)
北京大学学报(医学版) Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
9815
期刊介绍: Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases. The Journal has been indexed and abstracted by PubMed Central (PMC), MEDLINE/PubMed, EBSCO, Embase, Scopus, Chemical Abstracts (CA), Western Pacific Region Index Medicus (WPR), JSTChina, and almost all the Chinese sciences and technical index systems, including Chinese Science and Technology Paper Citation Database (CSTPCD), Chinese Science Citation Database (CSCD), China BioMedical Bibliographic Database (CBM), CMCI, Chinese Biological Abstracts, China National Academic Magazine Data-Base (CNKI), Wanfang Data (ChinaInfo), etc.
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