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[产前超声诊断异常及产前治疗程序的意义]

[Prenatal sonographic diagnosis of abnormalities and the significance of prepartum therapeutic procedures].

作者信息

Siekmann U, Irresberger P

出版信息

Dtsch Med Wochenschr. 1986 Oct 10;111(41):1554-60. doi: 10.1055/s-2008-1068670.

Abstract

Between 1981 and October 1985, prenatal ultrasound examinations revealed 19 malformations of the central nervous system, 13 intestinal malformations, 15 malformations of the urogenital tract, four non-immunological cases of hydrops fetalis, two sacral teratomas and one cardiac malformation. In only one of eleven cases of hydrocephalus were all preconditions fulfilled for considering an intra-uterine ventriculo-amniotic shunt insertion. In bilateral obstructive uropathy the dynamics of amniotic fluid volume both before and after intra-amniotic administration of an infusion is decisive for any further prognostic assessment. There are marked differences regarding the neonatal survival rate between the various organ-specific malformations (gastro-intestinal: 31%; hydrocephalus: 55%; obstructive uropathy: 89%). Personal experience suggests that there are only a few cases requiring intra-uterine, predominantly invasive, treatment. The value of prenatal ultrasound examination lies mainly in early diagnosis and the resulting choice of subsequent obstetric measures. Of particular importance is an interdisciplinary collaboration with specialists in allied fields.

摘要

1981年至1985年10月期间,产前超声检查发现19例中枢神经系统畸形、13例肠道畸形、15例泌尿生殖道畸形、4例非免疫性胎儿水肿、2例骶尾部畸胎瘤和1例心脏畸形。在11例脑积水病例中,只有1例满足考虑宫内脑室-羊膜分流置入的所有前提条件。在双侧梗阻性尿路病中,羊膜腔内输注前后羊水量的动态变化对进一步的预后评估起决定性作用。不同器官特异性畸形的新生儿存活率存在显著差异(胃肠道:31%;脑积水:55%;梗阻性尿路病:89%)。个人经验表明,只有少数病例需要宫内治疗,且主要是侵入性治疗。产前超声检查的价值主要在于早期诊断以及由此产生的后续产科措施的选择。与相关领域专家的跨学科合作尤为重要。

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