摘要
目的探讨复杂型和单纯型侧脑室扩张对胎儿出生预后的影响。方法收集2005年1月至2019年6月于本院超声检查发现胎儿侧脑室扩张病例163例,将其中14例复杂型侧脑室扩张(即侧脑室扩张伴其它结构异常)分为A组,将149例单纯型侧脑室扩张(即侧脑室扩张不伴其它结构异常)分为B组,所有163例侧脑室扩张者均行产前诊断,随访至胎儿出生后6个月至13岁。通过分析两组中胎儿染色体、宫内病毒感染等产前诊断结果,并对比随访结局,综合评价复杂型和单纯型侧脑室扩张对胎儿出生预后的影响。结果(1)在163例病例中,产前诊断结果阳性共有8例,其中染色体异常6例,染色体异常检出率为3.7%(6/163)。在有效随访的120例病例中,产前诊断结果阳性且随访结局阳性的有7例,产前诊断结果阴性且随访结局阴性的105例,产前诊断结果符合率为93.3%(112/120)。(2)在8例产前诊断结果阳性的病例中,中、重度侧脑室扩张各1例,均在A组,其余6例为轻度侧脑室扩张,其中5例在A组,1例在B组。在8例产前诊断结果阴性而随访结局阳性的病例中,最终发展为重度侧脑室扩张4例,其中2例在A组,2例在B组,其余4例均为轻度侧脑室扩张,均在A组。(3)A组中产前诊断结果阳性者7例(50%),阴性者7例(50%);B组中产前诊断结果阳性者1例(0.7%),阴性者148例(99.3%),两组比较,差异有统计学意义(χ~2值66.724,P=0.001)。(4)A组中随访结局阳性者12例,随访结局阴性者0例;B组中随访结局阳性者3例,随访结局阴性者105例,两组比较,差异有统计学意义(χ~2值93.333,P=0.001)。结论侧脑室增宽的胎儿预后主要取决于是否合并其它异常、侧脑室扩张程度以及在宫内和出生后的进展情况,因此应做好密切监测及出生后随访。
Objective:To compare prognosis differences between isolated fetal lateral ventriculomegaly(IFLV)and non-isolated fetal lateral vetriculomegaly(NIFLV).Methods:From Jan.2005 to Jun.2019,a total of one hundred and sixty-three cases were found among pregnant women underwent prenatal ultrasonography examination in Affiliated Foshan Maternity&Child Healthcare Hospital,Southern Medical University.Cases were divided into two groups:14 subjects with NIFLV(IFLV combined with other structural abnormalities)in group A and 149 subjects with IFLV in group B.All cases received prenatal diagnosis and followed up to 6 month^13 years postpartum.The prognosis differences were comprehensively evaluated by comparing the outcomes of prenatal diagnosis(e.g.fetal chromosome examination,virus infection)and follow-up between two groups.Results:(1)Eight of 163 cases tested positive for prenatal diagnosis.Six of 163 cases(3.7%)reported chromosomal abnormality.One hundred and twenty cases provide information of both prenatal diagnosis and follow-up outcomes,with seven cases reported both positive outcomes,and 105 cases reported both negative outcomes.The consistency rate of prenatal diagnosis was 93.3%(112/120).(2)Among eight positive prenatal diagnosis cases,the severity of fetal lateral ventriculomegaly(FLV)were mild in six cases(group A/group B:5/1),moderate in one cases(group A),and severe in one case(group A).Eight cases reported negative prenatal diagnosis outcomes,but turned out to be positive during follow-up,among whom four cases were with severe FLV(group A/group B:2/2),and four cases were with mild FLV(all in group A).(3)Half cases(n=7)in group A tested positive for prenatal diagnosis,with the rest(n=7,50%)tested negative.In group B,one case(0.7%)tested positive and 148 cases(99.3%)tested negative for prenatal diagnosis.Significant difference was found between two groups(χ~2=66.724,P=0.001).(4)Twelve cases reported positive outcome,and two cases lost during follow-up in group A.In group B,the outcomes were positive in three cases,and negative in another 105 cases,with another 41 cases lost during follow-up.Significant difference of follow-up outcomes was detected between group A and B(χ~2=93.333,P=0.001).Conclusions:The prognosis of fetal lateral ventriculomegaly was largely influenced by its subtype(IFLV or NIFLV),degree of lateral ventricular dilatation,and the progress both in uterus and after delivery.More measures are needed for better surveillance and postpartum follow-up.
作者
邓璐莎
郭晓玲
钟进
邓莎
范大志
陈耿东
DENG Lu-sha;GUO Xiao-ling;ZHONG Jin;DENG Sha;FAN Da-zhi;CHEN Geng-dong(Affiliated Foshan Maternity&Child Healthcare Hospital,Southern Medical University(The Second School of Clinical Medicine,Southern Medical University),foshan,Guangdong,528000,China)
出处
《中国优生与遗传杂志》
2020年第5期581-585,共5页
Chinese Journal of Birth Health & Heredity
关键词
侧脑室扩张
产前诊断
胎儿
超声检查
预后
Lateral ventriculomegaly
Prenatal diagnosis
Fetus
Ultrasonography
Prognosis
作者简介
通讯作者:郭晓玲
