超声诊断孤立性侧脑室增宽胎儿的宫内转归与临床预后

Intrauterine Outcome and Clinical Prognosis of Fetus with Isolated Lateral Ventricle Enlargement Diagnosed by Ultrasonography

【目的】探讨超声诊断孤立性侧脑室增宽(IVM)胎儿的宫内转归及临床预后情况。【方法】回顾性分析2013年1月至2017年12月在本院进行产前超声检查诊断的536例轻-中度IVM胎儿的宫内转归及出生后的预后情况。【结果】轻度IVM产前恢复率为74.70%(378/506),显著高于中度IVM恢复率的13.33%(4/30),其差异具有统计学意义(χ^2=52.092,P=0.000)。10例IVM胎儿出生后存在不同程度异常(1.87%,10/536),其中双侧IVM 6例(6.0%,6/100),单侧4例(0.92%,4/436),双侧IVM出生后发生异常的风险明显高于单侧IVM,差异具有统计学意义(χ^2=11.477,P=0.001)。轻度IVM中8例出生后存在神经行为异常(1.58%,8/506),中度IVM中2例出生后异常(6.67%,2/30),但轻中度神异常情况比较差异无明显统计学意义(χ^2=4.001,P=0.103)。【结论】大部分轻-中度IVM胎儿宫内转归及出生后预后良好,但存在一定生长发育、语言及智力发育等神经行为异常的风险,尤其是发生于双侧IVM,应重视出生后的随诊。

【Objective】To investigate the intrauterine outcomes and clinical prognosis of fetuses with isolated ventriculomegaly(IVM)diagnosed by ultrasound.【Methods】Retrospective analysis of 536 cases of mild to moderate IVM fetuses diagnosed by prenatal ultrasound in our hospital from January 2013 to December 2017 were retrospectively analyzed.【Results】The prenatal recovery rate of mild IVM was 74.70%(378/506),which was significantly higher than 13.33%(4/30)of moderate IVM(χ^2=52.092,P=0.000).There were different degrees of abnormalities in 10 cases of IVM(1.87%,10/536),including 6 cases of bilateral IVM(6.0%,6/100)and 4 cases of unilateral(0.92%,4/436).The risk of abnormal birth in bilateral IVM was significantly higher than that in unilateral IVM(χ^2=11.477,P=0.001).There were 8 cases of postnatal neurobehavioral abnormalities(1.58%,8/506)in mild IVM and 2 cases(6.67%,2/30)in moderate IVM,but there was no significant difference in mild to moderate mental disorders(χ^2=4.001,P=0.103).【Conclusion】Most of the mild to moderate IVM fetuses have good intrauterine outcome and postnatal prognosis,but there is a certain risk of neurobehavioral abnormalities such as growth and development,language and intelligence development,especially in bilateral IVM.Therefore,attention should be paid to the follow-up after birth.