Institute for Women's Health, University College London, London, UK.
Fetal Medicine Unit, University College London Hospitals, London, UK.
Prenat Diagn. 2021 Jan;41(2):248-257. doi: 10.1002/pd.5869. Epub 2020 Dec 15.
Fetal dural sinus thrombosis (DST) is a rare condition. Although numerous case reports exist, the findings appear heterogenous and providing accurate patient counselling remains challenging.
A systematic literature review was conducted in accordance with PRISMA guidance.
Thirty-one studies including 78 patients were included in this review. No association with maternal or neonatal coagulopathy, infection or trauma was found. The average gestational age at diagnosis was 25 weeks (range 17-34 weeks). Approximately half of foetuses affected were female (48.7%); one quarter were male (25.6%) and one quarter had no sex stated (25.6%). Termination of pregnancy was chosen in 25.6% of cases (20/78). In continuing pregnancies,10.3% (6/58) experienced a perinatal death. Antenatally, the majority of lesions either decreased in size (38.5%) or completely resolved (32.7%). The neonatal or childhood outcome was normal in 88.0% of survivors (44/50). The average age at follow up was 16.4 months, ranging from birth to 6 years.
This review found that 10% of DST cases experience in-utero or neonatal death. In survivors, the majority of cases reduce in size or completely resolve in pregnancy and 85% are reported to have a good outcome. However, further evidence is needed regarding long-term neurocognitive sequelae.
胎儿硬脑膜窦血栓形成（DST）是一种罕见的情况。尽管有许多病例报告，但这些发现似乎存在异质性，准确的患者咨询仍然具有挑战性。
根据 PRISMA 指南进行了系统的文献回顾。
本综述纳入了 31 项研究，共 78 例患者。未发现与母体或新生儿凝血功能障碍、感染或创伤有关。诊断时的平均孕龄为 25 周（范围 17-34 周）。受影响的胎儿中约有一半为女性（48.7%）；四分之一为男性（25.6%），四分之一未说明性别（25.6%）。25.6%（20/78）的病例选择终止妊娠。在继续妊娠的病例中，10.3%（6/58）发生围产儿死亡。在产前，大多数病变要么缩小（38.5%），要么完全消退（32.7%）。88.0%（44/50）的幸存者的新生儿或儿童结局正常。随访的平均年龄为 16.4 个月，范围从出生到 6 岁。
本综述发现 10%DST 病例在宫内或新生儿期死亡。在幸存者中，大多数病例在妊娠期间缩小或完全消退，85%的病例报告预后良好。然而，需要进一步的证据来了解长期的神经认知后遗症。
