Shigeta Naoya, Kanagawa Takeshi, Mimura Kazuya, Kimura Tadashi
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
Congenit Anom (Kyoto). 2015 Nov;55(4):183-5. doi: 10.1111/cga.12110.
Severe micrognathia can lead to death shortly after birth without a proper resuscitation. However, it is difficult to develop an effective resuscitation strategy without a prenatal diagnosis of the severity of micrognathia. In the present case, we used fetal three-dimensional computed tomography (3D-CT) to assess the severity of micrognathia. Its images clearly demonstrated bony framework of mandible and suggested that mandibular hypoplasia was too severe to allow for oral intubation. We therefore decided that the ex utero intrapartum treatment (EXIT) procedure would be more appropriate to establish the airway at birth. The prenatal 3D-CT is useful to evaluate the mandibular anatomy in utero if the severity of the micrognathia is not confirmed by the ultrasound or magnetic resonance imaging (MRI).
严重小颌畸形若没有适当的复苏措施,可在出生后不久导致死亡。然而,在产前未诊断出小颌畸形的严重程度时,很难制定有效的复苏策略。在本病例中,我们使用胎儿三维计算机断层扫描(3D-CT)来评估小颌畸形的严重程度。其图像清晰地显示了下颌骨的骨骼结构,并提示下颌发育不全过于严重,无法进行口腔插管。因此,我们决定出生时采用产时宫外治疗(EXIT)程序建立气道更为合适。如果超声或磁共振成像(MRI)未确认小颌畸形的严重程度,产前3D-CT有助于评估子宫内的下颌骨解剖结构。