66例胎儿腹腔积液的病因及妊娠结局
摘要
目的:探讨胎儿腹腔积液的病因、诊断、临床特点及预后。方法:回顾分析2013年6月至2018年6于郑州大学第一附属医院产科就诊的66例经彩超诊断为胎儿腹腔积液患者的临床资料(其中双胎4例,单绒双羊3例,双绒双羊1例,所有双胎均只有一胎受累)。结果:66例患者中,36例(54.5%)彩超发现胎儿水肿综合征相关表现,30例(45.5%)患者除腹腔积液外无其他部位积液或水肿,即单纯性腹腔积液。选择放弃胎儿者49例(其中5例胎死宫内);选择继续妊娠者17例,其中13例随访预后良好,4例于产后死亡。结论:对于胎儿腹腔积液的患者,无需盲目终止妊娠,通过详细的产前检查、病因学分析、围产期治疗,部分患者亦可获得良好的妊娠结局。
引文
[1]林胜谋,方群,王晨虹,等.胎儿腹水的产前诊断与预后[J].中华围产医学杂志,2009,12(6):413-417
[2]余蕴华,刘善英.母儿血型不合的诊断与治疗[J].中国实用妇科与产科杂志,2001,17(10):583-584
[3]Dreux S,Salomon LJ,Rosenblatt J,et al.Biochemical analysis of ascites fluid as an aid to etiological diagnosis:a series of 100 cases of nonimmune fetal ascites[J].Prenatal Diagn,2015,35(3):214-220
[4]El Bishry G.The outcome of isolated fetal ascites[J].Eur JObstet Gynecol Reprod Biol,2008,137(1):43-46
[5]Nose S,Usui N,Soh H,et al.The prognostic factors and the outcome of primary isolated fetal ascites[J].Pediat Surg Int,2011,27(8):799-804
[6]朴金花.母儿血型不合致胎儿水肿的临床超声分析[J].中国保健营养,2015,25(11):128-129
[7]Donofrio MT,Moon-Grady AJ,Hornberger LK,et al.Diagnosis and treatment of fetal cardiac disease:a scientific statement from the American Heart Association[J].Circulation,2014,129(21):2183-2242
[8]Bettelheim D,Pumberger W,Deutinger J,et al.Prenatal diagnosis of fetal urinary ascites[J].Ultrasound Obstet Gynecol,2000,16(5):473-475
[9]李龙,魏延栋,董宁,等.婴幼儿先天性乳糜性腹水病因及治疗的探讨[J].中华小儿外科杂志,2016,37(2):131-133
[10]Landolsi H,Yacoubi MT,Bouslama L,et al.Detection of the human Parvovirus B19 in nonimmune hydrops fetalis using immunohistochemistry and nested-PCR in formalinfixed and paraffin-embedded placenta and fetal tissues[J].Pathol Biol,2009,57(3):1-7
[11]Rossi G,Cosmi E,Trevisanuto D,et al.Umbilical arterial necrotic vasculopathy associated with fetal ascites[J].Fetal Diagn Ther,2010,27(2):110-112
[12]Sato Y,Benirschke K.Umbilical arterial thrombosis with vascular wall necrosis:clinicopathologic findings of 11cases[J].Placenta,2006,27(6-7):715-718
[13]Schmider A,Henrich W,Reles A,et al.Etiology and prognosis of fetal ascites[J].Fetal Diag Ther,2003,18(4):230-236
[14]Saleh N,Geipel A,Gembruch U,et al.Prenatal diagnosis and postnatal management of meconium peritonitis[J].JPerinat Med,2009,37(5):535-538
[15]Ping LM,Rajadurai VS,Saffari SE,et al.Meconium peritonitis:correlation of antenatal diagnosis and postnatal outcome-an institutional experience over 10 Years[J].Fetal Diagn Ther,2017,42(1):57-62
[16]林胜谋,方群.胎儿腹水的病因与预后[J].国外医学(妇产科学分册),2004,31(6):385
[17]Heinonen S,Ryynanen M,Kirkinen P.Etiology and outcome of second trimester non-immunologic fetal hydrops[J].Acta Obstet Gynecol Scand,2000,79(1):15-18
[18]Rubod C,Houfflin V,Belot F,et al.Deruelle.Successful in utero treatment of chronic and massive fetomaternal hemorrhage with fetal hydrops[J].Fetal Diag Ther,2006,21(5):410-413
[2]余蕴华,刘善英.母儿血型不合的诊断与治疗[J].中国实用妇科与产科杂志,2001,17(10):583-584
[3]Dreux S,Salomon LJ,Rosenblatt J,et al.Biochemical analysis of ascites fluid as an aid to etiological diagnosis:a series of 100 cases of nonimmune fetal ascites[J].Prenatal Diagn,2015,35(3):214-220
[4]El Bishry G.The outcome of isolated fetal ascites[J].Eur JObstet Gynecol Reprod Biol,2008,137(1):43-46
[5]Nose S,Usui N,Soh H,et al.The prognostic factors and the outcome of primary isolated fetal ascites[J].Pediat Surg Int,2011,27(8):799-804
[6]朴金花.母儿血型不合致胎儿水肿的临床超声分析[J].中国保健营养,2015,25(11):128-129
[7]Donofrio MT,Moon-Grady AJ,Hornberger LK,et al.Diagnosis and treatment of fetal cardiac disease:a scientific statement from the American Heart Association[J].Circulation,2014,129(21):2183-2242
[8]Bettelheim D,Pumberger W,Deutinger J,et al.Prenatal diagnosis of fetal urinary ascites[J].Ultrasound Obstet Gynecol,2000,16(5):473-475
[9]李龙,魏延栋,董宁,等.婴幼儿先天性乳糜性腹水病因及治疗的探讨[J].中华小儿外科杂志,2016,37(2):131-133
[10]Landolsi H,Yacoubi MT,Bouslama L,et al.Detection of the human Parvovirus B19 in nonimmune hydrops fetalis using immunohistochemistry and nested-PCR in formalinfixed and paraffin-embedded placenta and fetal tissues[J].Pathol Biol,2009,57(3):1-7
[11]Rossi G,Cosmi E,Trevisanuto D,et al.Umbilical arterial necrotic vasculopathy associated with fetal ascites[J].Fetal Diagn Ther,2010,27(2):110-112
[12]Sato Y,Benirschke K.Umbilical arterial thrombosis with vascular wall necrosis:clinicopathologic findings of 11cases[J].Placenta,2006,27(6-7):715-718
[13]Schmider A,Henrich W,Reles A,et al.Etiology and prognosis of fetal ascites[J].Fetal Diag Ther,2003,18(4):230-236
[14]Saleh N,Geipel A,Gembruch U,et al.Prenatal diagnosis and postnatal management of meconium peritonitis[J].JPerinat Med,2009,37(5):535-538
[15]Ping LM,Rajadurai VS,Saffari SE,et al.Meconium peritonitis:correlation of antenatal diagnosis and postnatal outcome-an institutional experience over 10 Years[J].Fetal Diagn Ther,2017,42(1):57-62
[16]林胜谋,方群.胎儿腹水的病因与预后[J].国外医学(妇产科学分册),2004,31(6):385
[17]Heinonen S,Ryynanen M,Kirkinen P.Etiology and outcome of second trimester non-immunologic fetal hydrops[J].Acta Obstet Gynecol Scand,2000,79(1):15-18
[18]Rubod C,Houfflin V,Belot F,et al.Deruelle.Successful in utero treatment of chronic and massive fetomaternal hemorrhage with fetal hydrops[J].Fetal Diag Ther,2006,21(5):410-413