Liang Mei-Ying, Wang Hong-Bin, Huang Xin, Wei Yan-Qiu
Department of Obstetrics, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Fu Chan Ke Za Zhi. 2007 Sep;42(9):582-5.
To discuss the clinical management and significance of the prenatal diagnosis of Fetal Choroid Plexus Cysts (CPC).
From May 2004 to March 2007, 55 cases of fetal CPC diagnosed by B-ultrasound during second trimester were prospectively studied. Each case was studied regarding fetal chromosome karyotype, disappearance weeks of the cyst, the clinical outcome and follow-up results respectively.
The cases were diagnosed during 16 - 25 gestational weeks. The diameters of the cysts varied from 0.2 cm to 2.4 cm. There were 25 cases of bilateral cysts and 30 cases of unilateral or 50 cases of isolated CPC and 5 cases of complicated CPC. The cysts of all cases who continued pregnancy disappeared before 28 weeks. Fetal chromosome karyotypes were obtained in 50 cases. Among them, two cases were 18-trisomy, and one case was 21-trisomy. Five cases were terminated pregnancy because of abnormal chromosome karyotype or malformation during second trimester. One neonate was diagnosed as ventricular septal defect among 50 cases of follow up. Among these six cases, three were from advanced-age pregnant women, five cases were with abnormal fetal structure and five cases were with the diameter of bilateral or unilateral cysts more than 1.0 cm.
(1) Fetal CPC can be diagnosed during second trimester, and the majority disappear before 28 gestational weeks. (2) High risk factors for fetal abnormal chromosome karyotype may be: advanced-age pregnant women, abnormal structure of fetus, and the diameter of bilateral or unilateral cyst more than 1.0 cm. It is suggested that fetal CPC with the high risks should receive fetal chromosome karyotype test during pregnancy.
探讨胎儿脉络丛囊肿(CPC)产前诊断的临床处理及意义。
对2004年5月至2007年3月孕中期经B超诊断为胎儿CPC的55例病例进行前瞻性研究。分别对每例病例的胎儿染色体核型、囊肿消失孕周、临床结局及随访结果进行研究。
病例诊断孕周为16~25周。囊肿直径0.2~2.4 cm。双侧囊肿25例,单侧或孤立性CPC 30例,复杂性CPC 5例。所有继续妊娠病例的囊肿在28周前消失。50例获得胎儿染色体核型。其中,2例为18-三体,1例为21-三体。5例因染色体核型异常或孕中期畸形而终止妊娠。随访的50例中有1例新生儿诊断为室间隔缺损。这6例中,3例来自高龄孕妇,5例胎儿结构异常,5例双侧或单侧囊肿直径大于1.0 cm。
(1)胎儿CPC可在孕中期诊断,多数在孕28周前消失。(2)胎儿染色体核型异常的高危因素可能为:高龄孕妇、胎儿结构异常、双侧或单侧囊肿直径大于1.0 cm。建议具有高危因素的胎儿CPC孕妇孕期行胎儿染色体核型检测。