McDevitt Helen, Kubba Haytham, Macara Lena, Reynolds Ben, Simpson Judith
Queen Mother's Hospital, Yorkhill Division, Glasgow, Scotland.
Acta Paediatr. 2007 Oct;96(10):1542-5. doi: 10.1111/j.1651-2227.2007.00177.x. Epub 2007 Sep 10.
Congenital anomalies causing airway obstruction in the newborn are potentially fatal. However if an effective airway can be maintained the long-term prognosis is often excellent. We present four cases of airway obstruction, three of which were diagnosed antenatally. We discuss the role of antenatal imaging and review delivery options including the need for a multidisciplinary team approach. In conclusion, we recommend antenatal imaging with both ultrasound scan and magnetic resonance to inform perinatal management. Polyhydramnios, in association with suspected neonatal airway obstruction, should alert clinicians to a high-risk situation. We recognize that even in skilled hands, securing an airway can be very difficult and alternatives such as maintenance of the fetomaternal circulation or extra-corporeal life support should be considered.
导致新生儿气道阻塞的先天性异常可能是致命的。然而,如果能够维持有效的气道,长期预后通常良好。我们报告了4例气道阻塞病例,其中3例在产前被诊断出来。我们讨论了产前影像学的作用,并回顾了分娩方式,包括多学科团队协作方法的必要性。总之,我们建议进行超声扫描和磁共振成像的产前影像学检查,以指导围产期管理。羊水过多,伴有疑似新生儿气道阻塞,应提醒临床医生注意高危情况。我们认识到,即使在技术熟练的医生手中,确保气道通畅也可能非常困难,应考虑诸如维持胎儿-母体循环或体外生命支持等替代方法。