완전 융모양막분리: 2예
Two cases of complete chorioamniotic membrane separation
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양막과 융모막은 임신 14주에서 16주경에 융합이 일어나므로, 임신 14주 이전에 초음파상 양막과 융모막이 분리되어 보이는 현상은 정상소견이다. 그러나 16주 이후에도 계속 분리되어 보이는 것은 비정상이며 드문 현상이다. 이와 같은 융모양막분리 는 자연적으로 발생할 수도 있으나 주로 양수검사와 같은 시술의 합병증으로 생긴다. 완전 융모양막분리가 발생한 경우 자 궁 내 태아사망, 제대이상 그리고 조기진통 등으로 태아 유병률과 사망률이 유의하게 증가하므로 입원하여 집중 치료하는 것이 매우 중요하다. 본 저자들은 이전 임신력에서 정상소견을 보인 임신 24주의 임산부에서 자연적으로 발생한 완전 융모 양막분리를 입원 치료하여 임신 29주 3일에 생존태아를 분만한 1예와 양수검사 후 발생한 완전 융모양막분리를 임신 21주에 진단하였으나 양막띠에 의한 제대협착이 발생하여 임신 24주에 자궁 내 태아사망하여 임신 종결한 1예를 각각 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
As chorion and amnion fusion usually occurs between 14 and 16 weeks of gestation, sonographic identification of chorion and amniotic membrane separation is a normal finding before 14 weeks. However, persistent separation after 16 weeks of gestation is considered rare and abnormal findings. Complete chorioamniotic membrane separation (CMS) may occur spontaneously, but has also been described as a complication of all invasive intrauterine procedures, including amniocentesis. Complete CMS have a significant morbidity and mortality due to intrauterine fetal death, cord complications, and preterm delivery. Aggressive treatment with hospitalization is necessary. We now report 2 cases of complete CMS identified by prenatal ultrasound; 1 in spontaneous complete CMS diagnosed at 24 weeks of gestation, and health premature child was born at 29+3 weeks of gestation, who was alive and well at present; 1 in complete CMS diagnosed at 21 weeks of gestation after amniocentesis, and fetal demise at 24 weeks of gestation due to cord strangulation by an amniotic band. We experienced two cases of complete CMS and report with a brief review of literatures.
참고문헌 (9)
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