摘要
目的:探讨产前超声诊断不同种类胎儿畸形的处理及预后分析。方法:总结146例产前超声检查时诊断的畸形胎儿的处理和随访结果。结果:(1)146例畸形胎儿中98例选择引产,其中有7例为染色体异常(1例13-三体,4例21-三体,2例18-三体)。(2)48例非致死性畸形在知情同意前提下选择继续妊娠。1例胎粪性腹膜炎,伴胎儿宫内发育迟缓,29周发生胎盘早剥,死胎引产,胎儿染色体正常;1例胎儿肠管明显扩张,伴羊水过多,37周早破水分娩,新生儿开腹手术后,发现未见肝脾胃,放弃手术死亡;1例先天性膈疝,伴左肺发育不良,生后当天死亡,死于双侧肺不张。3例泌尿系统异常恢复正常。1例双侧肾积水,合并羊水过多,产后44天手术,右侧肾盂与输尿管交接处狭窄;2例尚在观察中。4例卵巢囊肿生后消失,健康存活。11例轻度脑室扩张者,7例生后追踪未见异常,1例发展为显性脑积水,1例非典型Dany-walker综合症,生后1岁随访生长发育正常,智力发育与同龄儿童相当;2例尚在追踪观察中。1例胸腔积液胎儿,生后住院引流17天,健康出院。13例生后动态观察追踪。结论:非致死性胎儿畸形和异常在知情同意的前提下与儿科合作,针对异常情况可以通过手术或密切观察得到良好的结局。
Objective To explore the treatment and the prognosis for fetal anomaly diagnosed by antenatal sonography.Methods The treatment and the prognosis for 146 cases of featus anomalies diagnosed by antenatal sonography were summarized.Results Among the 146 cases of featus anomalies,induced abortion was administrated to 98 cases with chromosomal abnormality detected in 7 cases.48 cases diagnosed as fatal abnormity were consented to continue the gestation.During the follow-up,meconium peritonitis with intrauterine growth retardation was detected in 1 case.Placental abruption happened in the 29th gestational week and induced abortion was performed to the dead fetal with normal chromosome.Intestinal distension could be found in 1 case with hydramnios and early delivery happened in the 37th gestational week with a neonatus born without the organs of liver,spleen and stomach.Therefore,the surgery was quit and the neonatus died.One case with congenital diaphragmatic hernia and left pulmonary hypoplasia died of bilateral pulmonary atelectasis on the day of birth.A surgery was performed in 1 case of bilateral hydronephrosis with hydramnios for the stenosis in the junction between right pelvis and ureter in 44 days after birth.The other 2 cases were still under observation.Ovarian cysts disappeared in 4 cases after birth,who were survived healthy.Among the 11 cases with mild cerebral ventricular distention,no abnormality could be found in 7 cases,1 case progressed to dominant hydrocephaly,1 case of atypical dany-walker syndrome with normal growth and intelligence development,and 2 cases still under follow-up.With the treatment of drainage 17 days after birth,1 case of pleural effusion was discharged healthy.Dynamic observation were undergoing for 13 cases after their birth.Conclusion In the condition of informed consent obtained and with collaboration with pediatricians,non-fatal fetal anomaly and dysfunction could be treated with favorable outcomes under surgery or extensive observation.
出处
《中国农村卫生事业管理》
2011年第11期1183-1185,共3页
Chinese Rural Health Service Administration
关键词
产前
超声检查
胎儿畸形
预后
antenatal
sonography
fetal anomaly
prognosis
