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透明隔缺如:产前诊断及结局

Agenesis of the septum pellucidum: Prenatal diagnosis and outcome.

作者信息

Borkowski-Tillman Tamar, Garcia-Rodriguez Raquel, Viñals Fernando, Branco Miguel, Kradjen-Haratz Karina, Ben-Sira Liat, Lerman-Sagie Tally, Malinger Gustavo

机构信息

Division of Ultrasound in Obstetrics & Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Israel and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Prenatal Diagnosis and Fetal Therapy Unit, Obstetrics and Gynecology Service, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain.

出版信息

Prenat Diagn. 2020 May;40(6):674-680. doi: 10.1002/pd.5663. Epub 2020 Mar 31.

Abstract

OBJECTIVE

The purpose of this study is to describe the imaging findings in a group of fetuses with suspected agenesis of the septum pellucidum (ASP) and to evaluate their clinical outcome.

METHODS

This is a retrospective multicenter study on a cohort of fetuses diagnosed with suspected ASP, between 2008 and 2017. The records of each patient, including ultrasound (US) and magnetic resonance studies, were reviewed and compared with the postnatal findings.

RESULTS

Forty-seven patients were included in the study at a mean gestational age of 26.6 weeks. In 17 patients, the ASP was considered isolated. Fourteen patients delivered live-born, and all 14 are developing normally. Three were lost to follow-up. Twenty-four patients had associated malformations involving the central nervous system (CNS); 13 were delivered (normal development [5], abnormal [6] and no follow-up [2]). Nine patients opted for termination, and two pregnancies were lost to follow-up. Six patients had non-CNS associated findings, two were delivered with normal neurological development and four had a termination.

CONCLUSIONS

Isolated ASP is usually associated with a favorable outcome; but in the presence of associated malformations, there is at least a 50% risk of abnormal development. Current imaging techniques can provide an accurate prognosis in cases when ASP appears isolated.

摘要

目的

本研究旨在描述一组疑似透明隔缺如(ASP)胎儿的影像学表现,并评估其临床结局。

方法

这是一项对2008年至2017年间诊断为疑似ASP胎儿队列的回顾性多中心研究。回顾了每位患者的记录,包括超声(US)和磁共振检查结果,并与产后结果进行比较。

结果

47例患者纳入研究,平均孕周为26.6周。17例患者的ASP被认为是孤立性的。14例患者分娩出活产婴儿,且这14例均发育正常。3例失访。24例患者伴有涉及中枢神经系统(CNS)的相关畸形;13例分娩(发育正常[5例]、异常[6例]及未随访[2例])。9例患者选择终止妊娠,2例妊娠失访。6例患者有非CNS相关表现,2例分娩时神经发育正常,4例终止妊娠。

结论

孤立性ASP通常预后良好;但存在相关畸形时,至少有50%的异常发育风险。当ASP表现为孤立性时,当前的影像学技术可提供准确的预后评估。

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