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颅内脑膜瘤孕妇的管理策略和临床随访。

Management strategies and clinical follow-up of pregnant women with intracranial meningioma.

机构信息

Obstetrics and Gynecology Department, Clinical Hospital of Obstetrics and Gynecology "Filantropia", Bucharest, Romania.

Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

出版信息

J Med Life. 2021 Jan-Mar;14(1):2-6. doi: 10.25122/jml-2021-0012.

Abstract

Meningiomas are common primary tumors of the central nervous system. The incidence at the age of fertility is low, although there are some hormonal mechanisms involved. Growth in size was observed during the luteal phase of the menstrual cycle, which could lead to developing new symptoms during pregnancy or worsening of the already existing ones. Visual impairment is the chief complaint, followed by headache, nausea, vomiting, and seizures. Diagnosis is based on neurological examination, ophthalmoscopy, imaging techniques like gadolinium-enhanced magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CT) scans, bearing in mind the patient's irradiation and prejudice on the fetus together with the histopathological examination. The objective of the review is to determine the influence of meningioma on pregnancy and vice-versa and provide a strategy of follow-up for maternal-fetal specialists and not only. We performed a systematic review by searching relevant information in PubMed and Wiley databases using keywords as meningioma, pregnancy, progesterone receptors. The results showed that besides a similar incidence of meningioma in pregnant and non-pregnant women, symptoms might flare during pregnancy due to water retention, engorgement of vessels, and the presence of sex hormone receptors on tumor cells. Meningioma may impact the route of pregnancy with adverse effects on the fetus. Thus, fetal monitoring by biophysical profile and cardiotocography (CTG) is needed. The preferred treatment option is surgery, but gestational age and the woman's status must be taken into consideration.

摘要

脑膜瘤是中枢神经系统常见的原发性肿瘤。生育期的发病率较低,但涉及一些激素机制。在月经周期的黄体期观察到肿瘤大小的增长,这可能导致怀孕期间出现新的症状或已存在症状的恶化。视力障碍是主要症状,其次是头痛、恶心、呕吐和癫痫发作。诊断基于神经系统检查、眼底检查、成像技术,如钆增强磁共振成像(MRI)和对比增强计算机断层扫描(CT),同时考虑患者的辐射和对胎儿的偏见以及组织病理学检查。本次综述的目的是确定脑膜瘤对妊娠的影响以及反之亦然,并为母体-胎儿专家提供随访策略,而不仅仅是。我们通过在 PubMed 和 Wiley 数据库中使用脑膜瘤、妊娠、孕激素受体等关键词搜索相关信息,进行了系统综述。结果表明,除了妊娠和非妊娠妇女脑膜瘤的发病率相似外,由于水潴留、血管充血和肿瘤细胞上存在性激素受体,症状可能在怀孕期间加重。脑膜瘤可能会影响妊娠途径,对胎儿产生不良影响。因此,需要通过生物物理特征和胎心监护(CTG)进行胎儿监测。首选的治疗方法是手术,但必须考虑胎龄和妇女的状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecce/7982264/22c8340dc245/JMedLife-14-2-g001.jpg

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