胎儿脑室扩张的产前发现及相关生存率:一项前瞻性观察研究。

Prenatal findings and associated survival rates in fetal ventriculomegaly: A prospective observational study.

机构信息

UCD Perinatal Research Centre, University College Dublin, The National Maternity Hospital, Dublin, Ireland.

Fetal Medicine Department, The National Maternity Hospital, Dublin, Ireland.

出版信息

Int J Gynaecol Obstet. 2022 Dec;159(3):891-897. doi: 10.1002/ijgo.14206. Epub 2022 Apr 17.

Abstract

OBJECTIVES

Fetal ventriculomegaly is associated with varying degrees of genetic and structural abnormalities. The objective was to present the experience of fetal ventriculomegaly in a large European center in relation to: 1. grade of ventriculomegaly; 2. additional chromosomal/structural abnormalities; and 3. perinatal survival rates.

METHODS

This was a prospective observational study of patients referred with fetal ventriculomegaly from January 2011 to July 2020. Data were obtained from the hospital database and analyzed to determine the rate of isolated ventriculomegaly, associated structural abnormalities, chromosomal/genetic abnormalities, and survival rates. Data were stratified into three groups; mild (Vp = 10-12 mm), moderate (Vp = 13-15 mm) and severe (Vp > 15 mm) ventriculomegaly.

RESULTS

There were 213 fetuses included for analysis. Of these 42.7% had mild ventriculomegaly, 44.6% severe and 12.7% had moderate ventriculomegaly. Initial ultrasound assessment reported isolated ventriculomegaly in 45.5% fetuses, with additional structural abnormalities in 54.5%. The rate of chromosomal/genetic abnormalities was high,16.4%. After all investigations, the true rate of isolated VM was 36.1%. The overall survival was 85.6%. Survival was higher for those with isolated VM across all groups (P < 0.05).

CONCLUSION

Ventriculomegaly is a complex condition and patients should be counselled that even with apparently isolated VM, there remains the possibility of additional genetic and/or structural problems being diagnosed in up to 10% of fetuses.

摘要

目的

胎儿脑室扩张与不同程度的遗传和结构异常有关。本研究旨在报告在一个大型欧洲中心胎儿脑室扩张的经验,涉及:1.脑室扩张程度;2.额外的染色体/结构异常;3.围产儿存活率。

方法

这是一项对 2011 年 1 月至 2020 年 7 月期间因胎儿脑室扩张而转诊的患者进行的前瞻性观察性研究。数据来自医院数据库,用于确定孤立性脑室扩张、伴发结构异常、染色体/遗传异常的发生率和存活率。数据分为三组:轻度(VP=10-12mm)、中度(VP=13-15mm)和重度(VP>15mm)脑室扩张。

结果

共纳入 213 例胎儿进行分析。其中 42.7%为轻度脑室扩张,44.6%为重度脑室扩张,12.7%为中度脑室扩张。最初的超声评估报告 45.5%的胎儿为孤立性脑室扩张,54.5%伴有其他结构异常。染色体/遗传异常的发生率较高,为 16.4%。经过所有检查,真正的孤立性 VM 发生率为 36.1%。总体存活率为 85.6%。在所有组中,孤立性 VM 的存活率均较高(P<0.05)。

结论

脑室扩张是一种复杂的疾病,应告知患者,即使是在明显孤立性 VM 的情况下,仍有 10%的胎儿可能被诊断出存在其他遗传和/或结构问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10e3/9790218/fd0a8cb69965/IJGO-159-891-g001.jpg

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