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[宫内孤立性轻度胎儿脑室扩大的结局与预后]

[Outcome and prognosis of isolated mild fetal ventriculomegaly in uterus].

作者信息

Xie Ai-lan, Wang Yu-huan, Zhao Ya-ping, Ye Yi, Chen Xiao-ming, Jin Hui-pei, Zhu Xue-qiong

机构信息

Department of Obstetrics and Gynecology, Second Affiliated Hospital of Wenzhou Medical College, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2011 Jun;46(6):418-21.

Abstract

OBJECTIVE

To investigate outcome and prognosis of isolated mild fetal ventriculomegaly (IMV) of fetus in uterus.

METHODS

From Jan. 2006 to Dec. 2009, 18 200 singleton pregnancy women from 20 weeks gestation underwent prenatal ultrasonography examination in Department of Obstetrics and Gynecology, Second Affiliated Hospital of Wenzhou Medical College. One hundred and forty-eight women with IMV (transverse diameter of the atrium of the lateral ventricle measuring between 10 and 15 mm with no other abnormalities) were studied prospectively, which were divided into two groups: 99 women with transverse diameter of the lateral ventricle of 10 - 11 mm in group A and 49 women with transverse diameter lateral ventricle of 12 - 15 mm in group B. The changes of ventriculomegaly and the associated intracranial and extracranial anomalies were observed regularly every 2 or 4 weeks until delivery. The development of neurological system was also followed up.

RESULTS

(1) The overall incidence of IMV was 0.08% (148/18 200). The rate of bilateral ventriculomegaly were 20% (20/99) in group A and 51% (25/49) in group B, which reached statistical difference (P < 0.05). (2) Prognosis of fetus: 139 cases with 2 or more ultrasonographic examinations, IMV resolved throughout pregnancy in 41.7% (58/139), regressed in 7.9% (11/139), remained stable in 36.7% (51/139) and progressed in 13.7% (19/139). Five cases in group A and 11 cases in group B present progress, which reached significantly difference (P < 0.05). (3) One hundred and eleven cases infant were followed up for 5-12 months, the rate of psycho-motor developmental delay was 5.4% (6/111). The rate of neuro-developmental delay in progressed group (3/15) was higher than 2.5% (1/40) in resolved group, 0 (0/8) in regressed group and 4.2% (2/48) in remained stable group, which reached significantly difference (P < 0.05).

CONCLUSIONS

About 85% of cases of IMV resolved, regressed or remained stable in utero would exhibited good prognosis. IMV with a transverse atrial size ≥ 12 mm or progression in utero was usually associated with a poor prognosis, which should be observed carefully.

摘要

目的

探讨宫内胎儿孤立性轻度脑室扩张(IMV)的结局及预后。

方法

2006年1月至2009年12月,温州医学院附属第二医院妇产科对18200例孕20周的单胎妊娠妇女进行产前超声检查。前瞻性研究148例IMV患者(侧脑室房部横径为10~15mm且无其他异常),分为两组:A组99例,侧脑室横径为10~11mm;B组49例,侧脑室横径为12~15mm。每2或4周定期观察脑室扩张及相关颅内和颅外异常情况,直至分娩。同时对神经系统发育进行随访。

结果

(1)IMV的总体发生率为0.08%(148/18200)。A组双侧脑室扩张率为20%(20/99),B组为51%(25/49),差异有统计学意义(P<0.05)。(2)胎儿预后:139例接受2次或更多次超声检查,整个孕期IMV消失的占41.7%(58/139),缩小的占7.9%(11/139),保持稳定的占36.7%(51/139),进展的占13.7%(19/139)。A组5例、B组11例出现进展,差异有统计学意义(P<0.05)。(3)对111例婴儿进行5~12个月随访,精神运动发育迟缓率为5.4%(6/111)。进展组神经发育迟缓率(3/15)高于消失组的2.5%(1/40)、缩小组的0(0/8)和保持稳定组的4.2%(2/48),差异有统计学意义(P<0.05)。

结论

约85%宫内IMV消失、缩小或保持稳定的病例预后良好。侧脑室房部横径≥12mm或宫内进展的IMV通常预后不良,应密切观察。

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