孤立性轻度侧脑室增宽胎儿的宫内转归及妊娠结局

Intrauterine and pregnancy outcomes of isolated mild ventriculomegaly fetus

目的探讨产前超声诊断胎儿孤立性轻度侧脑室增宽(isolated mild ventriculomegaly,IMVM)的宫内转归及妊娠结局。方法回顾性分析2010年1月至2015年12月复旦大学附属妇产科医院诊断并能随访的88例IMVM胎儿的产检信息和妊娠结局。依据中孕期胎儿侧脑室宽度进行分组:侧脑室宽度10～10.9 mm (A组)侧脑室宽度11～12 mm (B组)。采用Pearson χ~2检验进行组间率的比较,多因素Logistic回归分析IMVM宫内转归的影响因素。结果产前IMVM总体恢复率为73.9%(65/88)。A组恢复率为82.1%(55/67),B组恢复率为47.6%(10/21),组间差异有统计学意义(P<0.05)。多因素Logistic回归分析显示首次检出IMVM时侧脑室宽度≥11 mm (OR=3.297,P=0.047)和首次检出时的孕周(OR=1.381,P=0.040)是影响IMVM宫内转归的危险因素。胎儿出生后随访2～5年,有远期随访结果的64例胎儿中(64/88,72.7%)58例(58/64,90.6%)生长发育正常,其余胎儿(6/64,9.4%)产后合并智力及语言发育障碍。结论大多数IMVM胎儿的宫内转归及预后较好;检出IMVM时侧脑室的宽度和孕周影响其宫内转归。

Objective To explore the intrauterine and pregnancy outcomes of isolated mild ventriculomegaly （IMVM） fetus. Methods Data of prenatal diagnosis and pregnancy outcomes were analyzed retrospectively in 88 fetuses with IMVM,whom were diagnosed at Obstetrics and Gynecology Hospital,Fudan University from Jan. , 2010 to Dec. , 2015. Eighty eight cases were divided into two groups according to ventricular width in the second trimester： group A （ventriculomegaly, 10 mm to 10.9 ram） and group B （ventriculomegaly,ll mm to 12 mm）. The comparison of intergroup rate was performed by Pearson chi square test, and multivariate logistic regression analysis was applied to identify the influence factors of IMVM hysteresis. Results The overall recovery rate of IMVM was 73.9% （65/88）. The recovery rate of IMVM was higher in group A （55/67,82. 1%） than that in group B （ 10/21,47.6%） with statistical differences （P〈0.05）. Multivariate Logistic regression analysis showed that the widths of lateral ventricle ≥11 mm （OR 3. 297, P=0. 047 ） and the gestational weeks at detection （OR 1. 381 ,P=0. 040） were the influence factors affecting intrauterie outcome of IMVM fetus. A total of 64 cases （after birth） had been followed up for 2 5 years. The growth and development were normal in 58 cases （58/64,90.6%） and intellectual and/or language development disorders were found in the rest cases （6/64,9.4%）. Conclusions The intrauterine outcomes and long term prognosis are good in most IMVM fetuses. The widths of lateral ventricle and the gestational weeks at detection can affect the intrauterie outcome of IMVM fetus.