Santolaya J, Alley D, Jaffe R, Warsof S L
Division of Maternal-Fetal Medicine, University of Illinois, Chicago.
Obstet Gynecol. 1992 Feb;79(2):256-9.
Among 12,572 pregnant women referred for ultrasound examination from 1985-1990, 76 fetuses had ultrasonographic findings of hydrops fetalis, ten immune and 66 nonimmune. Fetuses with cystic hygroma (20), heart defects or arrhythmias (13), or other congenital anomalies (15) accounted for the majority of the nonimmune cases. Antenatal chromosomal studies were available in 42 fetuses with nonimmune hydrops, of which 14 (34%) were abnormal with seven monosomes and six trisomies. Seventeen cases of hydrops (22%) were classified as idiopathic because they had no recognizable etiology. It is concluded that: 1) The ultrasonographic incidence of fetal hydrops in referral centers can be as high as one in 165 pregnancies; 2) most cases of fetal hydrops are of the nonimmune type, which can occur in a low-risk population and can be detected with early second-trimester ultrasound screening; and 3) the complexity of this condition and the high rate of chromosomal abnormalities require referral to a high-risk center for evaluation and pregnancy management.
在1985年至1990年间因超声检查而转诊的12,572名孕妇中，有76例胎儿有胎儿水肿的超声检查结果，其中10例为免疫性，66例为非免疫性。患有囊状水瘤（20例）、心脏缺陷或心律失常（13例）或其他先天性异常（15例）的胎儿占非免疫性病例的大多数。42例非免疫性水肿胎儿进行了产前染色体研究，其中14例（34%）异常，7例为单体，6例为三体。17例水肿（22%）被归类为特发性，因为它们没有可识别的病因。得出以下结论：1）转诊中心胎儿水肿的超声发生率可高达每165次妊娠中有1例；2）大多数胎儿水肿病例为非免疫性，可发生在低风险人群中，可通过孕中期早期超声筛查检测到；3）这种情况的复杂性和染色体异常的高发生率需要转诊至高危中心进行评估和妊娠管理。
