Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA 02111, USA.
Semin Perinatol. 2011 Oct;35(5):270-6. doi: 10.1053/j.semperi.2011.05.011.
Between 2% and 3% of pregnancies are complicated by fetal anomalies. For most anomalies, there is no advantage to late preterm or early-term delivery. The risks of maternal or fetal complication are specific for each anomaly. Very few anomalies pose potential maternal risk. Some anomalies carry ongoing risks to the fetus, such as an increased risk of fetal death, hemorrhage, or organ damage. In a limited number of select cases, the advantages of late preterm or early-term birth may include avoiding an ongoing risk of fetal death related to the anomaly, allowing delivery in a controlled setting with availability of subspecialists and allowing direct care for the neonate with organ injury. The optimal gestational age for delivery cannot be determined for all pregnancies complicated by fetal anomalies. For most pregnancies complicated by anomalies, there is no change to obstetrical management regarding timing of delivery. For those that may benefit from late preterm or early-term delivery, variability exists such that each management plan should be individualized.
2%-3%的妊娠会出现胎儿畸形。对于大多数畸形，晚期早产或早期足月分娩没有优势。母体或胎儿并发症的风险因每种异常而异。极少数畸形会对母体造成潜在风险。一些畸形会对胎儿持续存在风险，例如胎儿死亡、出血或器官损伤的风险增加。在极少数特定情况下，晚期早产或早期足月分娩的优势可能包括避免与畸形相关的持续胎儿死亡风险，允许在有专科医生和直接为有器官损伤的新生儿提供护理的可控环境中分娩。不能为所有伴有胎儿畸形的妊娠确定最佳分娩胎龄。对于大多数伴有畸形的妊娠，分娩时机的产科管理没有变化。对于那些可能受益于晚期早产或早期足月分娩的患者，存在一定的变异性，因此每个管理计划都应个体化。
