Obstetrics and Gynaecology, Catholic University of Sacred Heart, Rome, Italy.
Eur J Obstet Gynecol Reprod Biol. 2013 Oct;170(2):407-13. doi: 10.1016/j.ejogrb.2013.07.043. Epub 2013 Aug 14.
To evaluate the natural history of cystic hygroma (CH) in fetal and neonatal periods to enrich parental counselling. Ultrasonographic characteristics, associated syndromes, chromosomal anomalies, fetal cardiac pathology and life after birth were considered.
From May 1985 to September 2010, 207 pregnancies were seen the authors' centre with suspected vascular-lymphatic fetal malformation: 156 of them had CH. Cases were followed up by telephone interview to determine fetal and neonatal outcomes. Chi-squared test was used for statistical analysis.
Among the 156 cases of CH, the condition was septated in 75% of cases, associated with other pathologies in 74%, and retronuchal in 88%. Intrauterine regression was seen in 36% of cases, with complete disappearance in 77%. The karyotype was normal in 55% of cases. Follow-up was completed in 85 cases and revealed 54 spontaneous abortions (63%) and 31 live births (37%). Amongst these, 21 out of 31 children had a favourable outcome (68%). A negative embryo-fetal outcome was significantly associated with CH being associated with other pathologies, such as hydrops, retronuchal position and altered karyotype. Spontaneous regression or resolution of CH was associated with live births.
The management of pregnancies with a diagnosis of fetal CH requires knowledge of natural history of the malformation for appropriate parental counselling.
评估胎儿和新生儿期囊状水瘤（CH）的自然病程，丰富家长咨询内容。考虑了超声特征、相关综合征、染色体异常、胎儿心脏病理学和出生后的生活。
1985 年 5 月至 2010 年 9 月，作者所在中心对 207 例疑似血管淋巴管胎儿畸形的妊娠进行了检查：其中 156 例为 CH。通过电话访谈对病例进行随访，以确定胎儿和新生儿结局。采用卡方检验进行统计学分析。
在 156 例 CH 中，75%的病例呈分隔状，74%的病例与其他病变相关，88%的病例位于 retrunuchal 位置。36%的病例出现宫内消退，77%的病例完全消失。55%的病例核型正常。85 例完成随访，发现 54 例自然流产（63%）和 31 例活产（37%）。其中，31 名儿童中有 21 名（68%）预后良好。不良胚胎-胎儿结局与 CH 与其他病变（如水肿、retronuchal 位置和核型改变）相关显著相关。CH 的自发消退或解决与活产相关。
胎儿 CH 诊断后妊娠的处理需要了解畸形的自然病程，以便进行适当的家长咨询。
