Sebire N J, Jauniaux E
Department of Paediatric Pathology, Great Ormond Street Hospital, London, UK.
Ultrasound Obstet Gynecol. 2009 Feb;33(2):235-44. doi: 10.1002/uog.6246.
Fetal and placental malignancies are rare complications during pregnancy, but when they occur they may present significant challenges for the perinatology team. Owing to their rarity, there is limited information on many of these entities, with much data derived from individual case reports or small case series. Prenatal diagnosis of these entities is rare and inconsistent, usually in the form of isolated case reports. In the majority of fetal tumors, prenatal features are those of a mass lesion, with or without other non-specific features of fetal compromise such as polyhydramnios, fetal hydrops or intrauterine death, the final diagnosis in most cases being based on postnatal pathological examination.Expectant management is almost always indicated antenatally, with serial ultrasound examinations performed to detect rapid enlargement, metastasis or secondary fetal complications, such as non-immune hydrops, which may require intervention. Delivery should be planned in a specialist center in conjunction with pediatric surgeons and oncologists to allow appropriate neonatal management. Placental malignancy is most commonly in the form of gestatational trophoblastic disease, which requires assessment and management in specialist centers.
胎儿和胎盘恶性肿瘤是孕期罕见的并发症，但一旦发生，可能会给围产医学团队带来重大挑战。由于其罕见性，关于这些疾病的许多信息有限，大量数据来自个别病例报告或小病例系列。这些疾病的产前诊断罕见且不一致，通常以孤立病例报告的形式出现。在大多数胎儿肿瘤中，产前特征为肿块病变，伴有或不伴有胎儿窘迫的其他非特异性特征，如羊水过多、胎儿水肿或宫内死亡，大多数情况下最终诊断基于产后病理检查。几乎总是在产前进行期待治疗，通过系列超声检查来检测肿瘤快速增大、转移或继发性胎儿并发症，如非免疫性水肿，这可能需要干预。应在专科中心与小儿外科医生和肿瘤学家共同规划分娩，以便进行适当的新生儿管理。胎盘恶性肿瘤最常见的形式是妊娠滋养细胞疾病，这需要在专科中心进行评估和管理。
