Brezinka C, Gassner I, Huter O, Alge A
Universitäts-Klinik für Frauenheilkunde, Innsbruck.
Zentralbl Gynakol. 1990;112(22):1381-7.
When serious cerebral malformations of the fetal cerebrum are diagnosed, the pregnancy is in most cases so far advanced, that termination would be difficult medically, controversial ethically and--depending on legislation--impossible legally. Most cerebral malformations associated with hydrocephalus appear late in the 2nd and early in the 3rd trimester. Routine pregnancy ultrasound scan of the fetal brain is difficult due to the dynamic changes in cerebral anatomy during normal pregnancy and due to the artefacts produced by intra-cranial reverberations. The concept that there is a "right time" for in utero diagnosis of fetal hydrocephalus is reviewed. Unequivocal early diagnosis is only possible in cases of anencephaly. 15 cases of severe cerebral malformations that were seen during prenatal ultrasound at Innsbruck University Hospital are presented "Nonaggressive Obstetric Management" as a novel and structured approach to such cases is discussed.
当诊断出胎儿大脑存在严重脑畸形时，在大多数情况下，此时妊娠已进展到较晚期，以至于终止妊娠在医学上会很困难，在伦理上存在争议，并且根据不同的法律规定，在法律上可能无法实施。大多数与脑积水相关的脑畸形出现在妊娠中期的晚期和晚期妊娠的早期。由于正常妊娠期间脑解剖结构的动态变化以及颅内回声产生的伪像，对胎儿大脑进行常规妊娠超声扫描很困难。本文回顾了关于胎儿脑积水宫内诊断存在“合适时机”的概念。只有无脑儿病例才能明确早期诊断。本文介绍了因斯布鲁克大学医院产前超声检查时发现的15例严重脑畸形病例，并讨论了一种针对此类病例的新颖且结构化的“非激进产科管理”方法。
