胎儿处女膜闭锁的产前超声特征及预后

Prenatal Ultrasound Imaging Features and Prognosis of Congenital Imperforate Hymen

【目的】探讨胎儿处女膜闭锁的产前超声特征及预后。【方法】回顾性分析2018年1月至2020年7月在本院产前超声检查提示胎儿处女膜闭锁5例的临床资料,分析其超声特征,追踪其预后。【结果】处女膜闭锁超声特征:女性胎儿膀胱正后方有厚壁、囊性包块,边界清楚,其内可见絮状光点漂浮;彩色多普勒血流显像显示肿块未见明显血流信号。5例处女膜闭锁中,2例活产儿经超声、CT或MRI证实,其中1例出生后发现双肾积水和双肾多发结石;2例均进行处女膜切开术,引流出乳白色浓稠液体后,肿块消失,子宫下移至正常位置。另外3例合并其他畸形,1例合并左肾多囊性肾发育不全,1例合并单侧肾脏缺如,双下腔静脉及单脐动脉,1例合并右肾缺如,3例均终止妊娠,经尸体解剖证实。【结论】产前超声可及时发现处女膜闭锁,为临床治疗提供重要的依据,及时处理预后良好。

【Objective】To explore the prenatal ultrasound characteristics and outcomes in the diagnosis of fetal imperforate hymen.【Methods】All data of 5 cases with fetuses diagnosed congenital imperforate hymen from January 2018 to July 2020 in our hospital were retrospectively analyzed for the characteristics of ultrasound and clinical outcomes.【Results】The main echocardiographic features of congenital imperforate hymen were a thick-walled cystic mass behind the female fetus's bladder,with clear boundaries and irregular hyperechoic spots freely float in it.Color Doppler blood flow imaging showed no obvious blood flow signal.From this retrospective analysis,5 congenital imperforate hymens were identified in the diagnosis of fetuses.Of which 3 cases combined with other abnormalities(1 case had left kidney polycystic renal dysplasia,1 case had unilateral kidney absent,double inferior vena cava and single umbilical artery,1 case had right kidney absent)and confirmed by autopsy.And 2 live births were confirmed by ultrasound,CT or MRI(Hydronephrosis and multiple kidney stones were found in 1 case after birth).Both cases underwent hymenotomy.After the milky white thick liquid was drained,the mass disappeared and the uterus moved down to the normal position.Both live-born infants had a good prognosis.【Conclusion】Prenatal ultrasound can find congenital imperforate hymen in time and effectively,and provide important information for clinical treatment and follow-up.