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Fetal Arthrogryposis Secondary to a Giant Maternal Uterine Leiomyoma

机译:继发于巨大的母体子宫平滑肌瘤的胎儿关节变态

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Arthrogryposis multiplex congenital is a rare condition defined as contractures in multiple joints at birth due to disorders starting in fetal life. Its etiology is associated with many different conditions and in many instances remains unknown. The final common pathway to all of them is decreased fetal movement (fetal akinesia) due to an abnormal intrauterine environment. Causes of decreased fetal movements may be neuropathic abnormalities, abnormalities of connective tissue or muscle, intrauterine vascular compromise, maternal diseases, and space limitations within the uterus. When the cause of arthrogryposis is space limitations in uterus, the most common etiology is oligohydramnios. The same can result from intrauterine tumours as fibroids, although to our knowledge there are only two papers reporting cases of fetal deformities related to uterine leiomyomas. We describe a well-documented exceptional case of arthrogryposis associated with the presence of a large uterine fibroid. It could illustrate the importance of a careful and appropriate assessment of uterine fibroids before and in the course of a pregnancy considering that they can cause both serious maternal and fetal complications.
机译:多发性先天性关节病是一种罕见的疾病,定义为由于胎儿生命中的疾病导致出生时多个关节挛缩。其病因与许多不同的状况有关,在许多情况下仍然未知。子宫内环境异常导致胎儿运动减少(胎儿运动障碍)是导致这些疾病的最终共同途径。胎儿运动减少的原因可能是神经性异常,结缔组织或肌肉异常,子宫内血管受损,产妇疾病以及子宫内空间受限。当关节软化的病因是子宫空间受限时,最常见的病因是羊水过少。尽管据我们所知,仅有两篇论文报道了与子宫肌瘤相关的胎儿畸形病例,但子宫内瘤也可能与肌瘤相同。我们描述了与大子宫肌瘤的存在相关的关节置换的一个有案可稽的例外情况。考虑到子宫肌瘤会引起严重的母婴并发症,它可以说明在怀孕前和妊娠过程中对子宫肌瘤进行仔细,适当评估的重要性。

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