Obeidat Nail, Sallout Bahauddin, Albaqawi Badi, Al AlAali Wajeih
a Department of Obstetrics and Gynecology , King Abdullah University Hospital, Jordan University of Science and Technology , Irbid , Jordan.
b Department of Fetal Medicine and Ultrasound , Women's' Specialized Hospital, King Fahad Medical City , Riyadh , Saudi Arabia.
J Matern Fetal Neonatal Med. 2018 Feb;31(4):413-417. doi: 10.1080/14767058.2017.1286318. Epub 2017 Feb 9.
The objective of this study is to investigate the impact of abnormal middle cerebral artery (MCA) Doppler on the perinatal mortality in fetuses with congenital hydrocephalus (CH).
A prospective study of all fetuses with CH who delivered at our hospital over a period of 7 years. Data were obtained from the ultrasound, Labor room and intensive neonatal care unit (NICU) database. The Perinatal mortality rates were evaluated in relation to the following measures, associated congenital anomalies, cortical mantle thickness (CMT), and MCA Doppler abnormalities (absent or reversed diastole). The main outcome measure was perinatal mortality rate in relation to MCA Doppler changes.
A total of 85 cases of CH were diagnosed and managed. The birth prevalence of CH was 2.44 per 1000 live births. On one hand, the perinatal mortality rate was higher in those fetuses with non-isolated hydrocephalus, (37.25% (19/51) versus (35.29% (12/34, p = 0.854 and in those cases with CMT <10 mm, 38.78% (19/49) versus 33.33% (12/36) in those with CMT >10 mm, p = 0.607. On the other hand, the perinatal mortality rate was significantly higher in those fetuses with abnormal MCA Doppler, (100% (13/13) versus 25% (18/72), OR = 78.0, 95% CI (5.52-44085124.60), p < 0.001.
Abnormal fetal MCA Doppler (absent or reversed diastole) appears to be a poor prognostic indicator with significantly high perinatal mortality in fetuses with CH.
本研究的目的是调查大脑中动脉（MCA）多普勒异常对先天性脑积水（CH）胎儿围产期死亡率的影响。
对我院7年间分娩的所有CH胎儿进行前瞻性研究。数据来自超声、产房和新生儿重症监护病房（NICU）数据库。根据以下指标评估围产期死亡率：相关先天性异常、皮质幔厚度（CMT）和MCA多普勒异常（舒张期血流缺失或反向）。主要观察指标是与MCA多普勒变化相关的围产期死亡率。
共诊断并处理85例CH病例。CH的出生患病率为每1000例活产2.44例。一方面，非孤立性脑积水胎儿的围产期死亡率较高，（37.25%（19/51）对35.29%（12/34），p = 0.854）；CMT<10 mm的病例中，围产期死亡率为38.78%（19/49），而CMT>10 mm的病例中为33.33%（12/36），p = 0.607。另一方面，MCA多普勒异常的胎儿围产期死亡率显著更高，（100%（13/13）对25%（18/72），OR = 78.0，95%CI（5.52 - 44085124.60），p < 0.001）。
胎儿MCA多普勒异常（舒张期血流缺失或反向）似乎是一个预后不良的指标，CH胎儿的围产期死亡率显著升高。
