Division of Neonatology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Am J Obstet Gynecol. 2013 Aug;209(2):114.e1-13. doi: 10.1016/j.ajog.2013.04.032. Epub 2013 Apr 26.
The objective of this study was to review the medical literature that has reported the risk for intrauterine fetal death (IUFD) in pregnancies with gastroschisis.
We systematically searched the literature to identify all published studies of IUFD and gastroschisis through June 2011 that were archived in MEDLINE, PubMed, or referenced in published manuscripts. The MESH terms gastroschisis or abdominal wall defect were used.
Fifty-four articles were included in the metaanalysis. There were 3276 pregnancies in the study and a pooled prevalence of IUFD of 4.48 per 100. Those articles that included gestational age of IUFD had a pooled prevalence of IUFD of 1.28 per 100 births at ≥36 weeks' gestation. The prevalence did not appear to increase at >35 weeks' gestation.
The overall incidence of IUFD in gastroschisis is much lower than previously reported. The largest risk of IUFD occurs before routine and elective early delivery would be acceptable. Risk for IUFD should not be the primary indication for routine elective preterm delivery in pregnancies that are affected by gastroschisis.
本研究旨在回顾医学文献中关于先天性脐膨出胎儿宫内死亡（IUFD）风险的报道。
我们系统地检索了文献，以确定截至 2011 年 6 月在 MEDLINE、PubMed 中存档的或发表的文献中报道的所有关于 IUFD 和先天性脐膨出的研究。使用了 MESH 术语“先天性脐膨出”或“腹壁缺陷”。
荟萃分析共纳入 54 篇文章。研究中有 3276 例妊娠，IUFD 的合并发生率为每 100 例 4.48。那些包括 IUFD 胎龄的文章的 IUFD 合并发生率为≥36 周妊娠每 100 例出生 1.28。似乎在>35 周妊娠时，发生率没有增加。
先天性脐膨出的 IUFD 总体发生率远低于先前报道的水平。最大的 IUFD 风险发生在常规和选择性早期分娩之前可以接受的时间点。对于患有先天性脐膨出的妊娠，IUFD 不应成为常规选择性早产的主要指征。
