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产前双泡征对围产结局的临床意义及文献复习。

Clinical significance of prenatal double bubble sign on perinatal outcome and literature review.

机构信息

Perinatology Department, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Health Science University, Istanbul, Turkey.

Pediatric Surgery Department, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Health Science University, Istanbul, Turkey.

出版信息

J Matern Fetal Neonatal Med. 2022 May;35(10):1841-1847. doi: 10.1080/14767058.2021.1874338. Epub 2021 Jan 17.

Abstract

OBJECTIVE

To determine the diagnostic accuracy of the double bubble sign in predicting duedonal obstruction, the prevalence of anomalies associated with congenital duedonal obstruction, and to evaluate the outcome of these pregnancies and review the literature.

METHODS

We analyzed that the cases with double bubble sign were detected in prenatal ultrasonography between January 2014 and December 2019. Ultrasound reports, karyotyping results, surgical confirmed diagnoses and long-term results were extracted from the hospital database.

RESULTS

Duodenal obstruction was detected in all operated cases with double bubble sign detected in prenatal ultrasonography. Karyotype anomaly was found in 63.9% and additional congenital anomaly was found in 69.4%. Adverse perinatal outcome was seen in 51.1% of cases. Adverse perinatal outcome was found significantly higher in abnormal karyotype and congenital anomaly groups than isolated group. 81.8% of the isolated cases lived after the operation. Only two isolated cases died.

CONCLUSION

The prenatal double bubble sign is a highly reliable predictor for duodenal obstruction and structural anomalies and/or genetic abnormalities are present in the majority of cases. Duodenal obstruction is isolated, the outcomes appear favorable.

摘要

目的

确定十二指肠梗阻的双重气液平面征象的诊断准确性、与先天性十二指肠梗阻相关的异常的发生率,并评估这些妊娠的结局并复习文献。

方法

我们分析了 2014 年 1 月至 2019 年 12 月期间产前超声检查中发现的双重气液平面征象的病例。从医院数据库中提取了超声报告、核型分析结果、手术确诊诊断和长期结果。

结果

所有经手术证实的双重气液平面征象病例均存在十二指肠梗阻。核型异常发生率为 63.9%,合并先天性异常发生率为 69.4%。51.1%的病例出现不良围产结局。异常核型和先天性异常组的不良围产结局发生率明显高于单纯组。孤立组中 81.8%的病例在手术后存活。仅有 2 例孤立病例死亡。

结论

产前双重气液平面征象是十二指肠梗阻的高度可靠预测指标,大多数病例存在结构异常和/或遗传异常。孤立性十二指肠梗阻的结局似乎较好。

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