剖宫产极低体重出生儿产伤:临床病例

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详细

目前,极低体重出生儿的比例有所增加。因此,早产是产伤的危险因素之一。在俄罗斯国内文献中,仅描述了足月新生儿的生物机制。与此同时,在国外,尸体剖检,尤其是极低出生体重儿的尸体剖检数量呈下降趋势。因此,积累极低体重出生儿产伤的实践经验具有重要意义。

本文描述了剖宫产极低体重出生儿产伤的形态特征。法医研究结果表明,产伤表现为由于胎儿通过子宫切口取出时受到挤压而造成的躯干、上肢和下肢软组织出血。同时,发现颅骨结构损伤、耳后软组织和左颞肌出血。

增加拉伸应力导致小脑幕和镰状韧带纤维分离,并在其后部形成硬脑膜内出血。因此,所描述的病例说明了紧急剖宫产手术导致的极低体重出生儿产伤的范围和特征。

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作者简介

Ekaterina Yu. Gorun

Moscow Regional Research and Clinical Institute

编辑信件的主要联系方式.
Email: katuhka30@mail.ru
ORCID iD: 0000-0002-7008-2975
SPIN 代码: 4298-5402

MD

俄罗斯联邦, 61/2 Shchepkina st, Moscow,129110

Sergey L. Parilov

Moscow Regional Research and Clinical Institute

Email: parilov.s@mail.ru
ORCID iD: 0000-0001-9888-4534
SPIN 代码: 1764-7532

MD

俄罗斯联邦, 61/2 Shchepkina st, Moscow,129110

Aleksandr V. Maximov

Moscow Regional Research and Clinical Institute; State University of Education

Email: mcsim2002@mail.ru
ORCID iD: 0000-0003-1936-4448
SPIN 代码: 3134-8457

MD, Dr. Sci. (Medicine), Assistant Professor

俄罗斯联邦, 61/2 Shchepkina st, Moscow,129110; Moscow

参考

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  2. Valiulina A Ya, Akhmadeyeva EN, Kryvkina NN. The problems and perspectives of successful resuscitation and rehabilitation children born with low and extremely low birth weight. The Bulletine of Contemporary Clinical Medicine. 2013;6(1):34–41. doi: 10.20969/VSKM.2013.6(1).34-41 EDN: PYUCNF
  3. Parilov SL. Birth trauma of the nervous system in children. Moscow: LAP LAMBERT Academic Publishing; 2018. (In Russ.)
  4. Kozlov YuA, Kapuller VM. Birth trauma of the abdominal organs and retroperitoneal space in newborns. Pediatriya. Zhurnal im. G.N. Speranskogo. 2020;99(5):175–184. doi: 10.24110/0031-403X-2020-99-5-175-184 EDN: MMIRUR
  5. de Sévaux JLH, Nikkels PGJ, Lequin MH, Groenendaal F. The value of autopsy in neonates in the 21st century. Neonatology. 2019;115(1):89–93. doi: 10.1159/000493003
  6. Patankar SP, Patankar SS. Penetrating abdominal injury and peritonitis: a rare case of birth Injury. Journal of Indian Association of Pediatric Surgeons. 2008;13(1):22–24. doi: 10.4103/0971-9261.42569
  7. Gorun EYu. Differential diagnosis of traumatic hemorrhages in a newborn with extremely low body weight during luminescence: a case from practice. In: Materials of the XI International Congress «Current issues of forensic medicine and expert practice — 2024». Moscow, 2024 Apr 17–18. P. 45–46. (In Russ)
  8. Parilov SL, Zemlyansky DYu, Gorun EYu, Koshak KV. Causes, features of the mechanism and expert interpretation of birth trauma in newborns with extremely low body weight (500–1000 g). Izbrannyye voprosy sudebno-meditsinskoy ekspertizy. 2020;19:97–100. (In Russ) EDN: LGVXLE
  9. Ailamazyan EK, Kulakov VI, Radzinsky VE, Savelyeva GM editors. Obstetrics: national guidelines. M.: GEOTAR-Media; 2014. (In Russ.)

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1. JATS XML
2. Fig. 1. Hemorrhages in the skin and soft tissues of the shoulder girdle on the right with transition to the scapular and paravertebral regions, the presence of a hematoma in the scapular region.

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3. Fig. 2. Hemorrhage into the serratus anterior muscle on the right.

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4. Fig. 3. Overlap of the parietal bones onto the frontal and occipital bones.

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5. Fig. 4. The falciform process has areas of fiber disintegration, with a rounded focal intradural hemorrhage 0.5×0.5 cm in the posterior part, measuring.

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