摘要
目的探讨胎儿胸腔积液(FHT)的产前诊断与妊娠结局,为胎儿胸腔积液的临床诊疗提供经验。方法选择2016年1月至2020年1月在广东省妇幼保健院产前超声提示FHT并成功随访到妊娠结局的病例365例,孕妇年龄范围为16~46岁,对产前临床资料及胎儿转归进行回顾性分析。结果365例FHT中,单纯胸腔积液61例(16.7%),合并1种或多种其他异常304例(83.3%);根据365例FHT的产前临床资料分为孤立性胎儿胸腔积液(IFHT)组163例和非孤立性胎儿胸腔积液(NFHT)组202例,NFHT组的胎儿水肿率、遗传学异常率和终止妊娠率均高于IFHT组(均P<0.05)。继续妊娠的153例FHT中,107例IFHT的胸腔积液消退率、宫内干预率和生存率均高于46例NFHT;107例IFHT中,胎儿水肿组(32例)双侧胸腔积液和重度胸腔积液的比例、宫内干预率及围生期病死率均高于无水肿组(75例)(均P<0.05);46例NFHT中,胎儿水肿组(14例)双侧胸腔积液比例及围生期病死率均高于无水肿组(32例)(均P<0.05)。结论产前区分孤立性和非孤立性FHT对妊娠结局有重要的意义。FHT合并胎儿其他异常时,胎儿遗传学异常的机会增加。IFHT总体预后好于NFHT,胎儿水肿是提示预后不良的重要指标。
Objective To explore the prenatal diagnosis of fetal hydrothorax(FHT)and pregnancy outcomes,and to provide management experiences for clinical diagnosis and treatment of FHT.Methods From January 2016 to January 2020,365 pregnant women(16 to 46 years old)who were diagnosed with FHT by prenatal ultrasound in Guangdong Women and Children's Hospital were selected and successfully followed up for pregnancy outcomes.The prenatal clinical data and fetal outcomes were retrospectively analyzed.Results Among 365 cases of FHT,there were 61 cases(16.7%)of simple pleural effusion,and 304 cases(83.3%)complicated by one or more other abnormalities.According to the prenatal clinical data of 365 cases of FHT,they were divided into two groups:163 cases with isolated fetal hydrothorax(IFHT)and 202 cases with non-isolated fetal hydrothorax(NFHT).The fetal edema rate,genetic abnormality rate,and rate of pregnancy termination in the NFHT group were higher than those in the IFHT group(all P<0.05).In 153 cases of FHT who continued pregnancy,the subsidence rate of hydrothorax,the rate of intrauterine intervention,and the survival rate of 107 cases of IFHT were higher than those of 46 cases of NFHT(all P<0.05).In 107 cases of IFHT,the rates of bilateral pleural effusion,severe pleural effusion,intrauterine intervention,and the perinatal mortality rate in the fetal edema group(32 cases)were higher than those in the non-edema group(75 cases)(all P<0.05).In 46 cases of NFHT,the rate of bilateral pleural effusion and the perinatal mortality rate in the fetal edema group(14 cases)were higher than those in the non-edema group(32 cases)(both P<0.05).Conclusions Prenatal identification of isolated and non-isolated FHT is significant for pregnancy outcomes.The incidence of fetal genetic abnormalities increases in FHT complicated by other abnormalities.The overall prognosis of IFHT is better than that of NFHT,and fetal edema is an important indicator of poor prognosis.
作者
刘向娇
欧阳春艳
尚宁
耿娟
陈紫霞
Liu Xiangjiao;Ouyang Chunyan;Shang Ning;Geng Juan;Chen Zixia(Department of Ultrasound,Guangdong Women and Children's Hospital,Guangzhou 511400,China)
出处
《国际医药卫生导报》
2021年第20期3131-3136,共6页
International Medicine and Health Guidance News
基金
广东省科技计划项目(2020A1414010171)。
关键词
胎儿胸腔积液
产前诊断
临床转归
Fetal hydrothorax
Prenatal diagnosis
Clinical outcomes