Division of Obstetrics and Gynecology, Kanagawa Children's Medical Center, Yokohama, Japan.
Division of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan.
Congenit Anom (Kyoto). 2021 Jul;61(4):118-126. doi: 10.1111/cga.12412. Epub 2021 Mar 3.
We studied 27 cases that were post or prenatally diagnosed with body stalk anomaly (BSA) using medical records of prenatal ultrasound findings, pregnancy outcomes, and fetal/neonatal prognosis during 1992 to 2018. Termination of pregnancy was chosen in 15 cases. Of the remaining 12 cases, seven were stillbirths and five were live births. Of seven stillbirths, intrauterine fetal demise occurred before onset of labor in four cases at 17 to 20th weeks of pregnancy. Pregnancy was continued in eight cases. Median gestational age of delivery was 33rd weeks of pregnancy. Median birth weight was 1198 g (range:482-1914 g). Vaginal delivery was chosen in six and caesarean delivery in two cases. Among six vaginally delivered cases, three (50%) fetuses were stillborn. All five live born neonates died within a few hours (16-133 minutes). Eighteen cases were confirmed as BSA postnatally by placental examination or autopsy at our hospital. Main prenatal ultrasonographic findings of them were abdominal wall defect (100%), absence of the umbilical cord (72%), abnormal spine (61%), and abnormal legs (50%). The most characteristic prenatal ultrasonography findings of BSA were the absence of free umbilical cord in the amniotic cavity and the presence of abdominal organs into the extraembryonic celom through abdominal wall defects. The autopsy showed severe pulmonary hypoplasia with the median lung/body weight ratio of 0.61% (range:0.34-0.85%). There were no cases of maternal morbidities. Our study provides important information about the pregnancy outcome and the fetal/neonatal outcome of BSA cases for the parents whose fetuses are diagnosed with BSA prenatally.
我们研究了 1992 年至 2018 年间通过产前超声检查结果、妊娠结局和胎儿/新生儿预后的病历,共 27 例产前或产后诊断为体干异常(BSA)的病例。15 例选择终止妊娠。在其余 12 例中,7 例为死胎,5 例为活产。7 例死胎中,4 例在妊娠 17 至 20 周时在分娩前发生宫内胎儿死亡。8 例继续妊娠。中位分娩孕周为 33 周。中位出生体重为 1198g(范围:482-1914g)。6 例选择阴道分娩,2 例选择剖宫产。在 6 例阴道分娩的病例中,有 3 例(50%)胎儿为死胎。所有 5 例活产新生儿均在数小时内死亡(16-133 分钟)。在我院,18 例通过胎盘检查或尸检证实为 BSA。他们的主要产前超声表现为腹壁缺损(100%)、脐带缺失(72%)、脊柱异常(61%)和下肢异常(50%)。BSA 的最典型产前超声表现为羊膜腔内无游离脐带,腹壁缺陷使腹腔脏器进入胚外体腔。尸检显示严重的肺发育不良,中位肺/体重比为 0.61%(范围:0.34-0.85%)。无母体并发症。我们的研究为胎儿产前诊断为 BSA 的父母提供了有关 BSA 病例妊娠结局和胎儿/新生儿结局的重要信息。