Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom,
Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
Fetal Diagn Ther. 2019;45(4):221-229. doi: 10.1159/000488940. Epub 2018 Jun 6.
The aim of this study was to characterise the imaging features seen in fetuses having undergone feticide by intracardiac potassium chloride injection compared to those of non-terminated fetuses at post-mortem magnetic resonance imaging (PMMRI).
A case-control study was performed comparing PMMRI findings between two groups of patients - those having undergone feticide were matched to a control group of miscarried/stillborn fetuses. The groups were matched according to gestational age, weight, and time since death. Two independent readers reviewed the PMMRI for thoracic, abdominal, and musculoskeletal imaging features. The Fishers exact test was conducted for differences between the patient groups.
Twenty-six cases of feticide (mean gestation 25 weeks [20-36]) and 75 non-terminated fetuses (mean gestation 26.7 weeks [19-36]) were compared. There was a higher proportion of feticide cases demonstrating pneumothorax (23.1 vs. 1.3%, p = 0.001), haemothorax (42.3 vs. 4%, p = 0.001), pneumopericardium (30.8 vs. 5.3%, p = 0.002), and haemopericardium (34.6 vs. 0%, p = 0.0001). Intracardiac gas and intra-abdominal findings were higher in the feticide group, but the differences were not statistically significant.
Characteristic PMMRI features of feticide can help improve reporter confidence in differentiating iatrogenic from physiological/pathological processes.
本研究旨在描述经心脏内氯化钾注射终止妊娠的胎儿与死后磁共振成像（PMRI）的非终止妊娠胎儿的影像学特征。
对两组患者进行病例对照研究，比较 PMMRI 结果。一组为行胎儿终止术的患者，与另一组自然流产/死胎患者相匹配。两组按胎龄、体重和死亡后时间进行匹配。两位独立的读者对胎儿的胸、腹和骨骼肌肉影像学特征进行了评估。采用 Fisher 确切检验比较两组患者之间的差异。
比较了 26 例胎儿终止术（平均孕周 25 周[20-36]）和 75 例非终止妊娠胎儿（平均孕周 26.7 周[19-36]）。胎儿终止术组气胸（23.1%比 1.3%，p=0.001）、血胸（42.3%比 4%，p=0.001）、心包积气（30.8%比 5.3%，p=0.002）和心包积血（34.6%比 0%，p=0.0001）的比例更高。胎儿终止术组的心脏内气体和腹腔内发现更多，但差异无统计学意义。
胎儿终止术的特征性 PMMRI 特征有助于提高报告员对医源性与生理/病理性过程的区分信心。
