资源有限环境中自然四胞胎妊娠的诊断和管理难题:病例报告。

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL
International Medical Case Reports Journal Pub Date : 2025-03-11 eCollection Date: 2025-01-01 DOI:10.2147/IMCRJ.S491180
Kevin Dominique Tjandraprawira, Dhanny Primantara Johari Santoso, Hartanto Bayuaji, Annisa Dewi Nugrahani, Dadan Susandi
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引用次数: 0

摘要

高阶妊娠被认为是高危妊娠,随之而来的是各种母胎并发症。高阶妊娠的诊断和管理面临着丰富而复杂的挑战,特别是在产前保健(ANC)往往不足的农村地区。延迟预约和低意识的并发症需要优先管理和转介到三级中心胎儿医学专业知识。这是我们在低资源环境下早产儿自然受孕四胞胎的处理经验。病例介绍:一个27岁的7.5个月妊娠初产妇提出早产。她的胎膜完好无损,胎儿运动活跃。她的病史值得注意,因为她的怀孕是自然怀孕,她的产前咨询错误地将她的怀孕确定为三胞胎怀孕。入院时,她的子宫高度为49厘米,宫颈扩张5-6厘米。由于她处于活产期,她接受了紧急剖腹产手术。分娩了4名新生儿,但由于基础设施的限制,只有2名新生儿被转移到新生儿重症监护病房。她顺利康复,两天后出院。然而,四个新生儿中只有两个最终存活下来。这四胞胎妊娠标志着多胎妊娠的相关并发症:绒毛膜性的错误识别;早产;以及早产导致的新生儿早期死亡。结论:高阶妊娠对诊断和治疗提出了挑战。早产及其相关的新生儿并发症是众所周知的并发症,多学科管理是至关重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosis and Management Challenges of Spontaneous Quadruplet Pregnancy in a Resource-Limited Setting: A Case Report.

Introduction: Higher-order pregnancy is considered as a high-risk pregnancy, followed by various maternal and foetal complications. The diagnosis and management of higher order pregnancy have abundant and complex challenges, especially in rural areas where antenatal care (ANC) is often inadequate. Late booking and low awareness of complications necessitates priority management and referral to a tertiary center for fetal medicine expertise. This is our experience managing a spontaneously conceived quadruplet pregnancy delivered prematurely in a low-resource setting.

Case presentations: A 27-years-old primigravida of 7.5 months of gestation presented with preterm labor. Her membrane was intact, and she noted active fetal movements. Her history was notable due to her pregnancy being spontaneously conceived and that her antenatal consultations had mistakenly identified her pregnancy as a triplet pregnancy. At presentation, her fundal height was 49 cm, and her cervix was 5-6 cm dilated. As she was in active labor, she underwent an emergency caesarean section. Four neonates were delivered but only two were transferred to the neonatal intensive care unit due to infrastructure limitations. She made an uneventful recovery and was discharged 2 days later. However, only two of four neonates eventually survived. This quadruplet pregnancy signified the pertinent complications of multifetal pregnancy: misidentification of chorionicity; preterm delivery; and early neonatal deaths due to prematurity.

Conclusion: Higher order pregnancies present their own challenges for diagnosis and treatment. Preterm delivery and its associated neonatal complications are well-known complications, and a multidisciplinary management is crucial.

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来源期刊
International Medical Case Reports Journal
International Medical Case Reports Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
1.40
自引率
0.00%
发文量
135
审稿时长
16 weeks
期刊介绍: International Medical Case Reports Journal is an international, peer-reviewed, open access, online journal publishing original case reports from all medical specialties. Submissions should not normally exceed 3,000 words or 4 published pages including figures, diagrams and references. As of 1st April 2019, the International Medical Case Reports Journal will no longer consider meta-analyses for publication.
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