雙胞胎妊娠早期破水病例報告

Premature Rupture of Membrane in Twin Pregnancy: A Case Report

早期破水在臨床上極度容易造成胎兒感染，並有早產的風險，若合併羊水過少的狀況，對胎兒更是不利。本病例為懷孕初期的雙胞胎，因產檢導致早期破水。住院期間配合使用至陰穴改變胎兒相對位置，並搭配益氣養血、固腎安胎中藥，以穩定母子身心狀況，最終得以順產。本個案為一32歲女性，於104年5月自然懷孕，雙胞胎。懷孕初期有小出血情況，懷孕第16週時接受羊膜穿刺檢查，而後發生早期破水的情形。早期破水來自A胎兒的胎膜破裂，而A胎兒持續受到B胎兒的擠壓，導致破水狀況加重，並且A胎兒出現羊水過少的情形。個案住院期間經婦產科的安胎治療以及中醫的介入，破水狀況趨於穩定，且A胎兒羊水量得以逐漸增加，於104年9月出院返家休養。個案於105年1月剖腹產生下兩胎兒，目前兩胎兒均已健康長大。早期破水在臨床上有諸多值得努力之處，故透過本病例報告供臨床研究及醫護人員參考與討論。

The premature rupture of membrane may cause infection, premature labor, even death. This case is a 32 year-old woman, who pregnanted in May 2015, twins. In September 2015, the patient recepted amniocentesis, and then premature rupture of membrane from one amnion was found. The patient was emergently hospitalized for treatment about one month, including using Traditional Chinese Medicine and acupoints massage. BL67 is an useful acupuncture point to change baby position; medicines for nourishing blood and qi, reinforcing kidney for tocolysis are helpful for increasing amniotic fluid. After the symptom got control, the patient went back home and got C/S in January 2016, and two babies grew up healthily. The method to treat membrane rupture, especially twin baby, is an important clinical question for us to research.