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单脐动脉/孤立性脉络膜血管病变胎儿的人口统计学和围产期结局数据。

Demographic and perinatal outcome data of fetuses with SUA/PRUV.

作者信息

Sun Lulu, Wang Yanlin

机构信息

a Department of Obstetrics and Gynecology , International Peace Maternity and Child Health Hospital of China Welfare Institute , Shanghai , China.

b Department of Prenatal Diagnosis Center , International Peace Maternity and Child Health Hospital of China Welfare Institute , Shanghai , China.

出版信息

J Matern Fetal Neonatal Med. 2018 May;31(9):1118-1123. doi: 10.1080/14767058.2017.1309384. Epub 2017 Apr 3.

DOI:10.1080/14767058.2017.1309384
PMID:28320222
Abstract

AIM

Identify structural anomalies and adverse pregnancy outcomes accompanying single umbilical artery (SUA) and persistent right umbilical vein (PRUV) and to investigate whether SUA and PRUV are associated with chromosomal abnormalities and if these defects warrant invasive antenatal diagnosis.

METHODS

We retrospectively analyzed pregnancies with an antenatal diagnosis of SUA/PRUV from the International Peace Maternity and Child Health Hospital (IPMCHH) database. Data of structural malformations, fetal karyotyping, and pregnancy outcomes were analyzed.

RESULTS

Results revealed that 13.9 and 7% of SUA and PRUV cases, respectively, had malformations. Furthermore, 60% of the malformations accompanying SUA were isolated congenital heart disease (CHD), and 50% of the malformations accompanying PRUV were multiple malformations including CHD. All primarily diagnosed isolated PRUV (iPRUV) cases and 92.6% of primarily diagnosed iSUA cases had normal fetal echocardiography. Cases of iSUA and iPRUV with indications of invasive antenatal diagnosis showed no chromosomal abnormalities. The emergency cesarean section rate did not differ between the study population and the IPMCHH general population (p = .184).

CONCLUSION

Patients of SUA and PRUV diagnosed in secondary hospitals should be referred to tertiary medical center for further ultrasonography. SUA and PRUV are not indicators for invasive antenatal diagnosis and selective cesarean section.

摘要

目的

识别单脐动脉(SUA)和持续性右脐静脉(PRUV)伴随的结构异常及不良妊娠结局,并研究SUA和PRUV是否与染色体异常相关,以及这些缺陷是否需要进行侵入性产前诊断。

方法

我们回顾性分析了国际和平妇幼保健院(IPMCHH)数据库中产前诊断为SUA/PRUV的妊娠病例。分析了结构畸形、胎儿核型分析和妊娠结局的数据。

结果

结果显示,SUA和PRUV病例中分别有13.9%和7%存在畸形。此外,SUA伴随的畸形中60%为孤立性先天性心脏病(CHD),PRUV伴随的畸形中50%为包括CHD在内的多发畸形。所有最初诊断为孤立性PRUV(iPRUV)的病例以及92.6%最初诊断为iSUA的病例胎儿超声心动图均正常。有侵入性产前诊断指征的iSUA和iPRUV病例未显示染色体异常。研究人群与IPMCHH普通人群的急诊剖宫产率无差异(p = 0.184)。

结论

在二级医院诊断为SUA和PRUV的患者应转诊至三级医疗中心进行进一步超声检查。SUA和PRUV不是侵入性产前诊断和选择性剖宫产的指征。

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引用本文的文献

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Diagnosis of single umbilical artery and risk of foetal congenital malformations by prenatal ultrasound: a retrospective study.产前超声诊断单脐动脉与胎儿先天性畸形风险:一项回顾性研究。
BMC Pregnancy Childbirth. 2024 Mar 12;24(1):193. doi: 10.1186/s12884-024-06375-5.
2
Persistent Right Umbilical Vein in Association With Single Umbilical Artery: A Case Report and Review of Literature.持续性右脐静脉合并单脐动脉:1例病例报告及文献复习
Cureus. 2023 Mar 22;15(3):e36544. doi: 10.7759/cureus.36544. eCollection 2023 Mar.
3
Prenatal diagnosis of persistent right umbilical vein - Incidence and clinical impact. A prospective study.
持续性右脐静脉的产前诊断——发病率及临床影响。一项前瞻性研究。
Aust N Z J Obstet Gynaecol. 2019 Feb;59(1):77-81. doi: 10.1111/ajo.12791. Epub 2018 Mar 2.