胎動不安（子宮頸閉鎖不全合併羊膜囊膨出）之中西醫結合治療病例報告

Integration of Traditional Chinese and Western Medicine in Cervical Incompetence with Bulging Bag of Membranes: A Case Report

34歲女性，G3P1AA1，於妊娠22週又5天，發現胎位下降和子宮頸長度過短(short cervix 1.4cm)，伴隨下腹部疼痛及下墜感，診斷為Cervical incompetence with bulging bag of membranes。於2022/10/15住院安胎，使用宮縮抑制劑Yutopar並進行子宮頸環紮手術以防止早產。住院期間因子宮收縮頻繁，腰痠、腹部下墜感伴隨陰道分泌物、身熱、眠差等症狀，2022/10/26會診中醫進行中西醫合併治療。中醫診斷為腎氣虧虛、肝鬱氣滯之胎動不安，治療方針為補腎固衝任以安胎，補益脾胃、疏肝理氣。患者於妊娠33週又6天，自然產下一名體重2,770公克之男嬰。由此病例我們討論中西醫結合治療安胎的療效與注意事項，以供臨床醫師參考。

A 34-year-old woman, G3P1AA1, at gestational age of 22 weeks and 5 days, presented with a descended fetal position and a short cervix measuring 1.4cm, accompanied by lower abdominal pain. Diagnosed with cervical incompetence with a bulging bag of membranes, a cervical cerclage procedure was performed to prevent premature birth, alongside the use of the tocolytic agent Yutopar. During hospitalization, she experienced frequent uterine contractions, lower back pain, abdominal descent sensation, vaginal discharge, fever, and poor sleep. She received Traditional Chinese Medicine (TCM) and Western medicine treatment. TCM diagnosis indicated deficient kidney qi and liver qi stagnation causing threatened abortion. Treatment involved tonifying kidneys to stabilize the fetus, strengthening spleen and stomach, and regulating liver qi. The patient delivered a male infant weighing 2,770g at gestational age of 33 weeks and 6 days via natural delivery. This case underscores the efficacy and considerations of TCM and Western medicine in ensuring fetal safety, offering clinical insights for healthcare providers.