一项胎儿尸检研究中检测到的泌尿系统异常的发生率。
The Frequencies of the Urinary Anomalies which were Detected in a Foetal Autopsy Study.
作者信息
Gupta Tulika, Kapoor Kanchan, Sharma A, Huria A
机构信息
Assistant Professor, Department of Anatomy, Post Graduate Institute of Medical Education & Research , Chandigarh, India.
出版信息
J Clin Diagn Res. 2012 Dec;6(10):1615-9. doi: 10.7860/JCDR/2012/4736.2622. Epub 2012 Dec 15.
AIM
The detection of foetal urinary abnormalities in the antenatal period will help in an adequate post natal management and it will also have a bearing on the decision of the termination of the pregnancy. The purpose of the present study was to detect urinary anomalies in the antenatal period by doing autopsies of the aborted foetuses.
SETTINGS AND DESIGN
A cross-sectional study.
METHODS AND MATERIAL
A total of 226 aborted foetuses were autopsied. The urinary anomalies which were related to the renal parenchyma, the pelvi-ureteral system and the urinary bladder were recorded. The associated anomalies of the other organ systems were also noted. The incidences of the different urinary anomalies among the aborted foetuses were calculated. The gestational ages at which the various anomalies were detected were also studied.
RESULTS
Twenty nine of the 226 fetuses were detected to have 34 urinary anomalies. Renal agenesis was the single most common anomaly. Overall, the anomalies which were related to the renal parenchyma accounted for 67.65 % of all the urinary anomalies, while the anomalies of the pelvi-ureteral system and the bladder constituted 20.59% of the detected urinary anomalies. The anomalies of the renal parenchyma (renal agenesis and horse-shoe and polycystic kidneys) were more frequently seen in the foetuses with a shorter gestational age as compared to the gestational ages of the foetuses which showed pelvi-ureteral anomalies. The cumulative incidence of the foetuses with urinary anomalies by 30 weeks of gestation was 12.83%.
CONCLUSIONS
A significant proportion of the aborted foetuses was detected to have urinary anomalies. An early antenatal detection of these and associated anomalies has significance, as this may help in an early postnatal diagnosis and management. The degree and the extent of the detected anomalies could also help in the decision making regarding the therapeutic abortions and the future pregnancies.
目的
产前检测胎儿泌尿系统异常有助于产后进行适当管理，也会对终止妊娠的决策产生影响。本研究的目的是通过对流产胎儿进行尸检来检测产前泌尿系统异常。
设置与设计
一项横断面研究。
方法与材料
共对226例流产胎儿进行尸检。记录与肾实质、肾盂输尿管系统及膀胱相关的泌尿系统异常。还记录了其他器官系统的相关异常。计算流产胎儿中不同泌尿系统异常的发生率。研究检测到各种异常时的孕周。
结果
226例胎儿中有29例被检测出有34处泌尿系统异常。肾缺如是最常见的单一异常。总体而言，与肾实质相关的异常占所有泌尿系统异常的67.65%，而肾盂输尿管系统和膀胱的异常占检测到的泌尿系统异常的20.59%。与出现肾盂输尿管异常的胎儿孕周相比，肾实质异常（肾缺如、马蹄肾和多囊肾）在孕周较短的胎儿中更常见。妊娠30周时泌尿系统异常胎儿的累积发生率为12.83%。
结论
检测发现相当比例的流产胎儿有泌尿系统异常。早期产前检测这些异常及相关异常具有重要意义，因为这可能有助于早期产后诊断和管理。检测到的异常程度和范围也有助于做出关于治疗性流产和未来妊娠的决策。
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