Saltzman D H, Frigoletto F D, Harlow B L, Barss V A, Benacerraf B R
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Obstet Gynecol. 1989 Jul;74(1):106-11.
Sonographic criteria were developed to aid in determining the cause of hydrops fetalis in 26 consecutive cases diagnosed antenatally. This enabled us to predict whether the hydrops was due to anemia-related causes (isoimmunization, fetomaternal hemorrhage, alpha-thalassemia) or non-anemia-related causes. Fetuses without anemia as the cause of hydrops most often exhibited pleural effusions (87%) or marked edema (62.5%). A combination of pleural effusions and marked edema was evident in fetuses without anemia 56.3% of the time. Those with anemia as the cause of hydrops were significantly less likely to exhibit pleural effusions (20%), marked edema (10%), or pleural effusions and marked edema (10%). A thickened placenta occurred significantly more frequently (80 versus 37%) in anemia-associated hydrops. With the use of cordocentesis and intravascular in utero transfusion, the early recognition and treatment of hydrops fetalis due to anemia should lead to improved outcome in fetuses so affected.
制定了超声检查标准，以协助确定26例产前诊断的胎儿水肿的病因。这使我们能够预测水肿是否由贫血相关原因（血型不合、胎儿-母体出血、α地中海贫血）或非贫血相关原因引起。非贫血导致水肿的胎儿最常出现胸腔积液（87%）或明显水肿（62.5%）。56.3%无贫血的胎儿同时出现胸腔积液和明显水肿。贫血导致水肿的胎儿出现胸腔积液（20%）、明显水肿（10%）或胸腔积液合并明显水肿（10%）的可能性显著降低。贫血相关水肿中胎盘增厚的发生率显著更高（80%对37%）。通过脐静脉穿刺和宫内血管内输血，对贫血所致胎儿水肿的早期识别和治疗应能改善受影响胎儿的预后。
