65例胎儿胸腔积液的产前诊断结果分析

Results of prenatal diagnosis in 65 fetuses with pleural effusion

目的报道胸腔积液胎儿的产前诊断结果,为临床咨询提供依据。方法收集三年65例胸腔积液胎儿的产前诊断资料,包括孕妇基本资料、胎儿的超声检查结果及产前诊断结果,对数据进行回顾性分析。结果在65例胎儿胸腔积液的病例中,13例(20.0%)染色体核型异常,5例(7.7%)Rh血型不合性溶血,2例(3.1%)宫内感染(1例风疹病毒,另1例B19病毒)。早孕期胸腔积液的胎儿染色体异常率显著高于中晚孕期病例(66.7%vs 15.3%)(P<0.001,χ2=17.25)。15例胎儿胸腔积液合并其他超声结构异常的胎儿,发现4例染色体微阵列阳性结果(26.7%)。结论胎儿胸腔积液病例应常规行产前诊断排除胎儿染色体异常;染色体微阵列分析能够提高染色体异常的检出率。

Objective:To analyze the results of prenatal diagnosis in 65 pregnancies with fetal pleural effusion.Methods:During a three-year period,65 pregnancies with fetal pleural effusion received invasive procedure whose fetuses were found to be.The main character of pregnancies,ultrasound data and prenatal diagnosis results were recorded in our database.A retrospective analysis of these data for three years was performed.Results:In 65 fetuses with pleural effusion,13 cases(20.0%)were diagnosed with chromosomal abnormality,5 cases(7.7%)with Rh incompatibility.2 cases with congenital infections.The incidence of chromosomal abnormality in fetuses with pleural effusion at first trimester is higher than that in the second and third trimester(66.7%vs 15.3%)(P<0.001,χ~2=17.25).15 cases with fetal pleural effusion and other structural defects were analyzed with array-CGH,4 cases showed pathogenic submicroscopic chromosomal abnormalities.Conclusions:Chromosomal analysis should be considered when the fetuses were found to be with pleural effusion.The incidence of chromosome abnormality is higher in fetuses with pleural effusion at first trimester than those at second and third trimester.The application of Chromosomal micro-array analysis will increase the detection rate of chromosomal abnormality for the fetuses with pleural effusion.