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一例复发性婴儿型多囊肾合并胎儿水肿。

A case of recurrent infantile polycystic kidney associated with hydrops fetalis.

作者信息

Kim C K, Kim S K, Yang Y H, Lee M S, Yoon J H, Park C I

出版信息

Yonsei Med J. 1989;30(1):95-103. doi: 10.3349/ymj.1989.30.1.95.

Abstract

Nonimmune hydrops fetalis is becoming a predominant form of fetal hydrops due to the declining incidence of immune hydrops fetalis triggered by Rh isoimmunization. Infantile polycystic kidney appeared to be related to hydrops fetalis whether it is causal or merely coincidental and may represent another entry to differential diagnoses. Infantile polycystic kidney was diagnosed by an elevated maternal serum alpha-fetoprotein (AFP) value coupled with an ultrasonographic abnormality scanned as a multicystic mass with ascites in the fetal abdomen antenatally. This study presents a case of infantile polycystic kidney that resulted in a stillborn baby with hydrops fetalis and extensive placental calcification; it was the first case in Korea in which nonimmune hydrops fetalis was associated with infantile polycystic kidney in consecutive siblings by autosomal recessive inheritance in one family. In addition, this paper comprehensively reviews the incidence, etiology, prenatal diagnosis and proper management of nonimmune hydrops fetalis.

摘要

由于Rh血型同种免疫引发的免疫性胎儿水肿发病率下降,非免疫性胎儿水肿正成为胎儿水肿的主要形式。婴儿型多囊肾似乎与胎儿水肿有关,无论是因果关系还是仅仅是巧合,它可能是鉴别诊断的另一个切入点。婴儿型多囊肾通过孕妇血清甲胎蛋白(AFP)值升高以及产前超声检查异常来诊断,超声检查显示胎儿腹部有一个伴有腹水的多囊性肿块。本研究报告了一例婴儿型多囊肾导致死产胎儿并伴有广泛胎盘钙化的病例;这是韩国首例一个家族中通过常染色体隐性遗传在连续的兄弟姐妹中出现非免疫性胎儿水肿与婴儿型多囊肾相关联的病例。此外,本文全面综述了非免疫性胎儿水肿的发病率、病因、产前诊断及恰当处理。

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