胎儿非免疫性水肿的诊治

Management of non-immune hydrops fetalis

胎儿非免疫性水肿指除因ABO及RH溶血以外的其他原因引起的胎儿水肿,是众多胎儿疾病的一种临床表现,病因繁多。多由孕期超声诊断,表现为超声发现胎儿多浆膜腔积液,皮肤水肿或胎盘肿大。发现后,应积极排查病因,其病因多样且治疗手段有限,胎儿病死率极高。一些情况可通过药物干预或手术治疗来改善预后,还有一些病例表现出自限性病程,预后良好。

Non-immune hydrops fetalis （NIHF） is edema of the fetus caused by non-immune reasons with the absence of Rhesus isoimmunization and his- tologic evidence of erythroblastosis. Many fetal and maternal disorders can present as hydrops fetalis. It could be diagnosed by fetus ultrasound with the presence of abnormal fluid accumialation in 2 or more fetal serous compartments together with generalized soft tissue edema or placental enlargement. Possible etiologies should be explored after diagnosis. NIHF has a muhifactorial causes and limited treatment, and still is associated with a high mortality rate. Medicine or surgical intervention may help in certain condition and in some cases it showed spontaneous resolution.