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病例报告:COVID-19大流行期间胎儿支气管源性囊肿的产前和产后管理

Case Report: Prenatal and Postnatal Management for Fetal Bronchogenic Cysts During the COVID-19 Pandemic.

作者信息

Cheng Lin, Duan Jie, Wang Mei, Lu Dan, Li Huan, Ma Jianhong, Liu Juan, Wang Cheng, Zhang Yuanzhen

机构信息

Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China.

Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, China.

出版信息

Front Pediatr. 2021 Jul 7;9:675883. doi: 10.3389/fped.2021.675883. eCollection 2021.

Abstract

A fetal bronchogenic cyst (BC) is a rare congenital anomaly with an incidence of 0.147-0.238‰. The coronavirus disease 2019 (COVID-19) pandemic, as a particular situation, hindered pregnant women from receiving periodic prenatal checkups. Until 34 weeks of gestation, a fetal case of the intrathoracic cyst was found by ultrasound examination. Further, MRI examination confirmed the diagnosis of the congenital mediastinal cystic lesion, probably a BC. Genetic testing was not conducted due to the COVID-19 pandemic. At 38 weeks of gestation with maternal COVID-19 testing negative, a live girl was delivered by cesarean section. Five months later, the child underwent bronchocystectomy, and the postoperative pathological lesions confirmed a (right upper mediastinum) BC. Herein, we reported the prenatal and postnatal management for a rare case of the congenital BC by multidisciplinary approaches during the COVID-19 pandemic. Fetal MRI and screening for fetal chromosomal abnormalities are especially recommended. This case contributes to the awareness that the COVID-19 pandemic interferes with regular follow-up schedules during pregnancy and may interfere with timely performed additional tests; which leads to more accurate genetic counseling. A combination of multidisciplinary approaches, including radiology, infection control, genetic counseling, obstetrics, and pediatric surgery, is pivotal for managing fetal BC during the COVID-19 pandemic.

摘要

胎儿支气管源性囊肿(BC)是一种罕见的先天性异常,发病率为0.147 - 0.238‰。2019年冠状病毒病(COVID - 19)大流行作为一种特殊情况,阻碍了孕妇接受定期产前检查。直到妊娠34周时,通过超声检查发现了一例胎儿胸腔内囊肿。进一步的MRI检查证实了先天性纵隔囊性病变的诊断,可能是BC。由于COVID - 19大流行,未进行基因检测。在妊娠38周时,产妇COVID - 19检测呈阴性,通过剖宫产分娩出一名活女婴。五个月后,患儿接受了支气管囊肿切除术,术后病理病变证实为(右上纵隔)BC。在此,我们报告了在COVID - 19大流行期间通过多学科方法对一例罕见的先天性BC进行的产前和产后管理。特别推荐进行胎儿MRI检查和胎儿染色体异常筛查。该病例使人们认识到COVID - 19大流行会干扰孕期的常规随访计划,并可能干扰及时进行的额外检查;这会导致更准确的遗传咨询。包括放射学、感染控制、遗传咨询、产科和小儿外科在内的多学科方法组合对于在COVID - 19大流行期间管理胎儿BC至关重要。

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