孕周对产前超声诊断胎儿腹腔积液及胎儿结局的影响

Impact of gestational age on prenatal ultrasonic diagnosis of fetal ascites and fetus'outcome

目的观察孕周对产前超声诊断胎儿腹腔积液及胎儿结局的影响。方法根据首诊胎儿腹腔积液时孕周将58例超声诊断胎儿腹腔积液孕妇(58胎)分为2组,Ⅰ组(<24周)20例,Ⅱ组(≥24周)38例;对比2组产前诊断结果及胎儿结局。结果58例中,54例(54/58,93.10%)产前诊断明确,4例为胎儿特发性腹腔积液(单纯性腹腔积液,未合并其他异常)。Ⅰ组产前诊断结果主要为胎儿消化系统疾病及水肿,Ⅱ组主要为胎儿消化系统疾病、水肿、泌尿生殖系统异常及循环系统异常等;Ⅰ组与Ⅱ组产前诊断差异无统计学意义(P均>0.05)。Ⅰ组12例(12/20,60.00%)终止妊娠,7例(7/20,35.00%)胎儿结局好;Ⅱ组10例(10/38,26.32%)终止妊娠,5例新生儿出生后7天内死亡(5/38,13.16%),20例(20/38,52.63%)胎儿结局好。Ⅰ组终止妊娠率高于Ⅱ组(χ^2=6.32,P=0.01)。结论孕周对产前诊断腹腔积液及胎儿结局均存在影响。

Objective To explore the impact of gestational age on prenatal ultrasonic diagnosis of fetal ascites and fetus'outcome.Methods Totally 58 pregnant women(58 fetuses)with fetal peritoneal effusion diagnosed with ultrasound were divided into 2 groups according to the gestational weeks of the first discovery of fetal peritoneal effusion,groupⅠ(<24 weeks)20 cases and groupⅡ(≥24 weeks)38 cases.Prenatal diagnosis and fetal outcomes were compared between the two groups.Results Among 58 fetuses,54(54/58,93.10%)had definite prenatal diagnosis,and 4 had idiopathic peritoneal effusion(simple ascites without other abnormalities).Prenatal diagnosis mainly included digestive system diseases and fetal edema in groupⅠ,mainly digestive system diseases,fetal edema,urogenital system abnormalities and circulatory system abnormalities in groupⅡ(all P>0.05).Pregnancy was terminated in 12 cases(12/20,60.00%)in groupⅠand 10 cases(10/38,26.32%)in groupⅡ.Seven cases(7/20,35.00%)in groupⅠand 20 cases(20/38,52.63%)in groupⅡhad good fetal outcome,but 5 newborns(5/38,13.16%)died within 7 days after birth in groupⅡ.The rate of termination in groupⅠwas higher than that in groupⅡ(χ^2=6.32,P=0.01).Conclusion Gestational age has impact on prenatal diagnosis and outcome of fetus with ascites.