非免疫性胎儿水肿11例临床分析

Clinicalanalysis of 11 cases of non-immune hydrops fetalis

目的 研究非免疫性胎儿水肿（NIHF）的临床特点.方法 回顾性分析2015年1月至2016年11月收治11例NIHF的影像学表现、病因分析、结局等.结果 产前超声结合胎儿MRI提示胸腔积液、腹腔积水及皮下水肿是胎儿水肿最常见的异常影像.11例中心脏异常2例,先天性乳糜胸3例,染色体异常1例,胎粪性腹膜炎1例,膀胱破裂1例,原因不明3例.3例在28周前终止妊娠,2例胎死宫内,活产儿6例,3例产后48 h内死亡,3例存活.8例病理为胎盘水肿.结论 NIHF病死率高,其病因、发病机制和终止妊娠的时机把握有待于继续探究.

Objective To research the clinical characteristics of neonates with non-immune hydrops fetalis.Methods The clinical data of eleven non-immune hydrops fetalis who admitted from January 2015 to November 2016 were retrospectively studied.Imaging manifestations,cause analysis and outcomes were explored and analyzed with descriptive statistical methods.Results The most common abnormal images in this study were hydrothorax,seroperitoneum and subcutaneous edema.Of all the cases,cardiac anomalies were in 2 cases,chylothorax in 3 cases,chromosome abnormality in 1 case,meconium peritonitis in 1 case,bladder rupture in 1 case and unknown reasons in 3 cases.Of all the cases,3 cases were terminated pregnancy before 28 weeks,2 cases were fetal intrauterine death,and 6 cases were live births,among whom 2 cases died within 48 h of newborn and 3 cases survived.Placental pathologic conditions of 8 cases were edematous placentas.Conclusions The mortality of non-immune hydrops fetalis is high.Its etiology,pathogenesis and the timing of pregnancy termination need to be explored.