产前超声诊断胎儿侧脑室增宽的临床意义
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摘要
目的 探讨产前超声诊断胎儿侧脑室增宽的临床意义。方法 回顾性分析2014年2月至2018年2月在北京怀柔医院进行超声诊断并留有完整档案的孕妇2 964例,将其中有侧脑室增宽的84例纳入观察组,另外2 880例无脑室增宽者纳入对照组。分析比较观察组与对照组胎儿先天性缺陷的高危因素、合并异常情况、围产结局及新生儿发育状况。结果 观察组孕妇中,大龄产妇、遗传病、吸烟、不良孕史、妊娠期服用高危药物、疾病感染和病毒携带的比例均高于对照组,差异均有统计学意义(χ~2值分别为64.038、158.014、60.038、185.389、71.459、42.493,均P<0.05)。观察组胎儿中的先天缺陷、肾脏异常、心脏异常、羊水异常、基因缺陷、脊柱裂和结构畸形的发生率均高于对照组,差异均有统计学意义(χ~2值分别为133.747、597.207、811.560、65.981、106.508、65.160、378.844,均P<0.05)。观察组孕妇引产率显著高于对照组,差异有统计学意义(χ~2=316.746,P<0.05);观察组新生儿正常发育的比例显著低于对照组,差异有统计学意义(χ~2=31.045,P<0.05)。结论 产前超声诊断胎儿侧脑室增宽有助于胎儿异常情况和先天性缺陷的辅助诊断。
Objective To explore the clinical significance of prenatal ultrasound in diagnosis of fetal lateral ventriculomegaly. Methods A total of 2 964 pregnant women who accepted ultrasound diagnosis and kept complete archives in Beijing Huairou Hospital during February 2014 to February 2018 were analyzed retrospectively. Among them, 84 patients with lateral ventriculomegaly were included in observation group, and 2 880 patients without ventriculomegaly were included in control group. The high-risk factors, combined abnormalities, perinatal outcomes and neonatal development of fetal congenital defects between two groups were analyzed and compared. Results Among the pregnant women in the observation group, the proportions of pregnant women in elderly age, with genetic diseases, with smoking, with poor pregnancy history, taking high-risk drugs during pregnancy, with disease infection and virus were higher than those of the control group, and the differences were statistically significant.(χ~2 value was 64.038, 158.014, 60.038, 185.389, 71.459 and 42.493, respectively, all P<0.05). The incidences of congenital defects, renal anomalies, cardiac anomalies, amniotic fluid anomalies, genetic defects, spina bifida and structural malformations in the observation group were all higher than those in the control group with significant differences(χ~2 value was 133.747, 597.207, 811.560, 65.981, 106.508, 65.160 and 378.844, respectively, all P<0.05). The rate of induced labor of pregnant women in the observation group was significantly lower than that in the control group, and the difference was statistically significant(χ~2=316.746, P<0.05). The proportion of normal neonatal development in the observation group was significantly lower, and the difference was statistically significant(χ~2 =31.045, P<0.05). Conclusion Prenatal ultrasound diagnosis of fetal lateral ventriculomegaly contributes to the auxiliary diagnosis of fetal abnormalities and congenital defects.
Objective To explore the clinical significance of prenatal ultrasound in diagnosis of fetal lateral ventriculomegaly. Methods A total of 2 964 pregnant women who accepted ultrasound diagnosis and kept complete archives in Beijing Huairou Hospital during February 2014 to February 2018 were analyzed retrospectively. Among them, 84 patients with lateral ventriculomegaly were included in observation group, and 2 880 patients without ventriculomegaly were included in control group. The high-risk factors, combined abnormalities, perinatal outcomes and neonatal development of fetal congenital defects between two groups were analyzed and compared. Results Among the pregnant women in the observation group, the proportions of pregnant women in elderly age, with genetic diseases, with smoking, with poor pregnancy history, taking high-risk drugs during pregnancy, with disease infection and virus were higher than those of the control group, and the differences were statistically significant.(χ~2 value was 64.038, 158.014, 60.038, 185.389, 71.459 and 42.493, respectively, all P<0.05). The incidences of congenital defects, renal anomalies, cardiac anomalies, amniotic fluid anomalies, genetic defects, spina bifida and structural malformations in the observation group were all higher than those in the control group with significant differences(χ~2 value was 133.747, 597.207, 811.560, 65.981, 106.508, 65.160 and 378.844, respectively, all P<0.05). The rate of induced labor of pregnant women in the observation group was significantly lower than that in the control group, and the difference was statistically significant(χ~2=316.746, P<0.05). The proportion of normal neonatal development in the observation group was significantly lower, and the difference was statistically significant(χ~2 =31.045, P<0.05). Conclusion Prenatal ultrasound diagnosis of fetal lateral ventriculomegaly contributes to the auxiliary diagnosis of fetal abnormalities and congenital defects.
引文
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[8]Tugcu A U,Gulumser C,Ecevit A,et al.Prenatal evaluation and postnatal early outcomes of fetal ventriculomegaly[J].Eur J Paediatr Neurol,2014,18(6):736-740.
[9]孙国玉,侯新琳,周丛乐.胎儿延续至新生儿期侧脑室增宽的诊断与预后[J].中华围产医学杂志,2016,19(6):446-449.
[10]Mckechnie L,Vasudevan C,Levene M.Neonatal outcome of congenital ventriculomegaly[J].Semin Fetal Neonatal Med,2012,17(5):301-307.
[11]Kandula T,Fahey M,Chalmers R,et al.Isolated ventricu-lomegaly on prenatal ultrasound:what does fetal MRI add?[J].J Med Imaging Radiat Oncol,2015,59(2):154-162.
[12]Chumann M,Hofmann A,Krutzke S K,et al.Array-based molecular karyotyping in fetuses with isolated brainmalformations identifies disease-causing CNVs[J].J Neurodev Disord,2016,8:11.
[13]房芳.超声诊断胎儿轻度侧脑室扩张的临床价值[J].现代诊断与治疗,2016,27(6):1124-1125.
[2]Perlman S,Shashar D,Hoffmann C,et al.Prenatal diagnosis of fetal ventriculomegaly:agreement between fetal brain ultrasonography and MR imaging[J].AJNR Am J Neuroradiol,2014,35(6):1214-1218.
[3]Scala C,Familiari A,Pinas A,et al.Perinatal and long-term outcomes in fetuses diagnosed with isolated unilateralventriculomegaly:systematic review and meta-analysis[J].Ultrasound in Obstet Gynecol,2017,49(4):450-459.
[4]White A L,Hedlund G L,Bale J F.Congenitalcytomegalovirus infection and brain clefting[J].Pediatric Neurology,2014,50(3):218-223.
[5]Stoll C,Dott B,Alembik Y,et al.Associated malformations among infants with neural tube defects[J].Am J Med Genet A,2011,155A(3):565-568.
[6]Gezer C,Ekin A,Ozeren M,et al.Chromosome abnormalityincidence in fetuses with cerebral ventriculomegaly[J].J Obstet Gynaecol,2014,34(5):387-391.
[7]谢爱兰,赵雅萍,叶祎,等.产前超声诊断轻度胎儿脑室扩张的临床意义[J].医学研究杂志,2012,41(2):78-81.
[8]Tugcu A U,Gulumser C,Ecevit A,et al.Prenatal evaluation and postnatal early outcomes of fetal ventriculomegaly[J].Eur J Paediatr Neurol,2014,18(6):736-740.
[9]孙国玉,侯新琳,周丛乐.胎儿延续至新生儿期侧脑室增宽的诊断与预后[J].中华围产医学杂志,2016,19(6):446-449.
[10]Mckechnie L,Vasudevan C,Levene M.Neonatal outcome of congenital ventriculomegaly[J].Semin Fetal Neonatal Med,2012,17(5):301-307.
[11]Kandula T,Fahey M,Chalmers R,et al.Isolated ventricu-lomegaly on prenatal ultrasound:what does fetal MRI add?[J].J Med Imaging Radiat Oncol,2015,59(2):154-162.
[12]Chumann M,Hofmann A,Krutzke S K,et al.Array-based molecular karyotyping in fetuses with isolated brainmalformations identifies disease-causing CNVs[J].J Neurodev Disord,2016,8:11.
[13]房芳.超声诊断胎儿轻度侧脑室扩张的临床价值[J].现代诊断与治疗,2016,27(6):1124-1125.