胎儿神经系统发育异常及其妊娠结局的分析

ANALYSIS OF 316 CASES OF FETAL NERVOUS SYSTEM ABNORMALITY AND PREGNANCY OUTCOME

目的讨论产前超声筛查胎儿神经系统先天发育异常不同类型的构成比及妊娠结局。方法对2014年2月—2017年2月参加唐山市妇幼保健院产前筛查多学科会诊的孕妇进行分析,将其中胎儿神经系统发育异常的病例纳入研究,回顾性分析其不同异常类型的构成,进一步分析其妊娠结局。结果在2100例参加多学科会诊的孕妇中筛查出胎儿神经系统发育异常的316例进行分析,其中侧脑室增宽123例,颅后窝池增宽58例,脉络丛囊肿48例,小脑病变32例,第五、六脑室增宽25例,神经管畸形10例,脑发育不良10例,胼胝体发育不良6例,蛛网膜囊肿4例。失访30例,脑积水或侧脑室扩张终止妊娠25例,其中合并无创产前DNA检测阳性2例,合并脑室出血1例,合并胼胝体发育不良2例,颅后窝池增宽终止妊娠3例,脉络丛囊肿合并18,三体高风险终止妊娠3例,脊柱裂合并脑积水终止妊娠3例,小脑发育不良中Dandy-walker综合征终止妊娠5例、自然流产1例,其他小脑病变6例终止妊娠、死产1例,胼胝体发育不良终止妊娠5例,脑发育不良10例均终止妊娠,第五、六脑室增宽合并颅骨内肿瘤终止妊娠1例。结论通过产前超声筛查,结合磁共振、无创产前DNA检测等检查,对严重畸形儿、染色体病患儿,及时终止妊娠,有效控制先天发育异常患儿的出生率,降低出生缺陷,同时减少过度引产。

Objective To discuss the prenatal ultrasound screening for fetal nervous System congenital a- nomalies of different types of constituent ratio and pregnancy outcome. Methods From February 2014 to February 2017 in author＇s hospital, all prenatal screening multidisciplinary consultation of pregnant women were analyzed, the fetal nervous system abnormalities were included in the study, a retrospective analysis of the different types of abnormal structure and outcome of pregnancy were performed： Results In 2100 cases of multidisciplinary consultation in pregnant women screening of fetal nervous system abnormalities were analyzed in 316 cases, including 123 cases of lateral ventricle, posterior fossa widened in 58 eases, 48 cases of choroid plexus cysts, 32 cases of cerebellar lesions, fifth and six ventricle 25 cases of neural tube defects in 10 cases, 10 cases of cerebral hypoplasia, agenesis of the corpus callosum in 6 cases, 4 cases of arachnoid cyst. Lost in 30 cases, hydrocephalus or dilated lateral ventricles termination of pregnancy in 25 cases, with non- invasive prenatal DNA test was positive in 2 cases, 1 case with intraventricular hemor- rhage with agenesis of the corpus callosum in 2 cases, the posterior fossa pool widened termination of preg- nancy in 3 cases, choroid plexus cyst with trisomy 18, high risk pregnancy termination 3 cases of spina bifi- da and hydrocephalus of termination of pregnancy in 3 cases, cerebellar hypoplasia in Dandy- walker syn- drome of termination of pregnancy in 5 cases, 1 case of spontaneous abortion and other cerebellar lesions in 6 cases of termination of pregnancy, 1 case of stillbirth, agenesis of the corpus callosum. Termination of pregnancy in 5 cases, cerebral dysplasia 10 cases were terminated pregnancy, fifth and sixth ventricle broadening of skull tumors in 1 case of termination of pregnancy. Conclusions Through prenatal ultra- sound screening, combined with magnetic resonance imaging and non- invasive prenatal DNA testing ex- amination of serious malformation and chromosome disease, timely termination of pregnancy, effective con- trol of children with abnormal congenital birth rate, reduce birth defects, while reducing excessive labor.