Lin Sheng-mou, Wang Chen-hong, Zhu Xiao-yu, Li Sheng-li, Lin Sai-mu, Fang Qun
Department of Obstetrics, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China.
Zhonghua Fu Chan Ke Za Zhi. 2011 Dec;46(12):905-10.
To investigate the ultrasound characteristics, etiology and prognosis in hydrops fetalis.
From September 2002 to May 2010, 156 hydrops fetalis presented in Shenzhen Maternity and Child Healthcare Hospital were studied retrospectively, including ultrasound characteristics, etiology, and prognosis.
All of the 112 typical hydrops fetalis, 20 cases with isolated ascites, 8 cases with isolated pleural effusion, 7 cases with isolated pericardial effusion, 5 cases with isolated subcutaneous edema, 4 cases with isolated placental thickening were observed by ultrasonography. The major etiology and associated diagnosis consisted of 35.9% (56/156) of non-immune anemia, 9.6% (15/156) of cardiac abnormalities, 7.1% (11/156) of intrauterine infection, 6.4% (10/156) of twin problems, 5.8% (9/156) of meconium peritonitis, 5.1% (8/156) of thoracic-lung disease, 4.5% (7/156) of chromosomal abnormalities, 1.9% (3/156) of immune anemia. Alpha thalassemia was the most common non-immune anemia (96%, 54/56). An etiology and associated diagnosis could be determined in 81.4% (127/156) of cases. Follow-up data showed that 7 cases were fetal death, 110 women elected to terminate their pregnancies, 3 cases lost follow-up, the other 36 cases preserve continuing pregnancy, including 28 liveborn infants and 8 fetal deaths. Etiology of twin-twin transfusion syndrome, meconium peritonitis, congenital chylothorax, intrauterine infection, cardiac abnormalities and so on had survived fetus cases. The survival rate of typical hydrops fetalis in the present series was 3.6% (4/112).
Ascites is the most common characteristics of sonogram in hydrops fetalis. The etiology of hydrops fetalis is extremely complex. The prognosis is associated with the etiology and hydrops subtype.
探讨胎儿水肿的超声特征、病因及预后。
回顾性分析2002年9月至2010年5月在深圳市妇幼保健院就诊的156例胎儿水肿病例,包括超声特征、病因及预后。
112例典型胎儿水肿、20例单纯腹水、8例单纯胸腔积液、7例单纯心包积液、5例单纯皮下水肿、4例单纯胎盘增厚均经超声检查发现。主要病因及相关诊断包括35.9%(56/156)的非免疫性贫血、9.6%(15/156)的心脏异常、7.1%(11/156)的宫内感染、6.4%(10/156)的双胎问题、5.8%(9/156)的胎粪性腹膜炎、5.1%(8/156)的胸肺疾病、4.5%(7/156)的染色体异常、1.9%(3/156)的免疫性贫血。α地中海贫血是最常见的非免疫性贫血(96%,54/56)。81.4%(127/156)的病例可确定病因及相关诊断。随访资料显示,7例胎儿死亡,110例孕妇选择终止妊娠,3例失访,其余36例继续妊娠,其中28例活产婴儿,8例胎儿死亡。双胎输血综合征、胎粪性腹膜炎、先天性乳糜胸、宫内感染、心脏异常等病因有存活胎儿病例。本系列典型胎儿水肿的存活率为3.6%(4/112)。
腹水是胎儿水肿最常见的超声特征。胎儿水肿的病因极为复杂。预后与病因及水肿亚型有关。