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三级医疗中心囊性水瘤病例的产前诊断及妊娠结局回顾性分析。

Prenatal diagnosis of cystic hygroma cases in a tertiary centre and retrospective analysis of pregnancy results.

作者信息

Demir Sureyya Saridas, Cagliyan Erkan, Öztürk Derya, Özmen Samican, Altunyurt Sabahattin, Çankaya Tufan, Bora Elcin

机构信息

Department of Obstetrics and Gynecology, Division of Perinatology, Dokuz Eylul University School of Medicine, Izmir, Turkey.

Department of Medical Genetics, Dokuz Eylul University School of Medicine, Izmir, Turkey.

出版信息

J Obstet Gynaecol. 2022 Oct;42(7):2899-2904. doi: 10.1080/01443615.2022.2112023. Epub 2022 Aug 25.

Abstract

The aim of this study is to retrospectively examine invasive diagnostic methods, structural anomalies accompanying cystic hygroma, and pregnancy outcomes in cystic hygroma cases admitted to a tertiary centre. The population of the study consisted of 29 live foetuses with cystic hygroma in the foetal neck only in the first or second trimester. In the study, pregnant women who applied to our centre were included. Amniocentesis or chorionic villus sampling was performed for genetic analysis according to the weeks of the pregnant women who were diagnosed with cystic hygroma by ultrasound examination by two clinicians experienced in foetal anomaly. Of the pregnant women included in the study, 10 had normal karyotype, 12 had abnormal karyotype and 13 had structural abnormality. It is very important to provide genetic counselling to the families of foetuses with cystic hygroma with a multidisciplinary team approach consisting of neonatologists, paediatric surgeons and experienced sonographers. Implications for rehabilitation Cystic hygroma, also known as cystic lymphangioma, is a congenital cystic malformation often seen in the first trimester, which occurs in the foetal neck due to the failure of the connections between the cervical lymphatic vessels and the jugular venous system to develop normally. Cystic hygroma may be isolated, but highly associated with foetal aneuploidy, hydrops fetalis, abnormal foetal nuchal translucency. Invasive prenatal diagnostic tests (CVS or amniocentesis) should be performed in all patients with cystic hygroma, as cystic hygromas can be diagnosed by first trimester foetal genetic sonogram screening and are largely accompanied by chromosomal abnormalities. In foetuses with cystic hygroma, foetal karyotyping, detailed sonography and their documentation, genetic counselling is important to families of cystic hygroma foetuses with a multidisciplinary team approach consisting of neonatologists, paediatric surgeons and maternal foetal medicine specialists, since there is a high risk for aneuploidy and foetal malformation.

摘要

本研究的目的是回顾性地研究一家三级中心收治的囊性水瘤病例的侵入性诊断方法、伴随囊性水瘤的结构异常以及妊娠结局。该研究的对象包括29例仅在孕早期或孕中期胎儿颈部出现囊性水瘤的活胎。在本研究中,纳入了前来我们中心就诊的孕妇。对于经两名胎儿异常诊断经验丰富的临床医生通过超声检查诊断为囊性水瘤的孕妇,根据孕周进行羊膜穿刺术或绒毛取样以进行基因分析。在纳入研究的孕妇中,10例核型正常,12例核型异常,13例存在结构异常。由新生儿科医生、小儿外科医生和经验丰富的超声检查医师组成的多学科团队为患有囊性水瘤胎儿的家庭提供遗传咨询非常重要。康复意义 囊性水瘤,也称为囊性淋巴管瘤,是一种常见于孕早期的先天性囊性畸形,由于颈部淋巴管与颈静脉系统之间的连接未能正常发育,发生于胎儿颈部。囊性水瘤可能是孤立的,但与胎儿非整倍体、胎儿水肿、胎儿颈部半透明层异常高度相关。所有患有囊性水瘤的患者均应进行侵入性产前诊断检查(绒毛取样或羊膜穿刺术),因为囊性水瘤可通过孕早期胎儿基因超声筛查诊断,且大多伴有染色体异常。对于患有囊性水瘤的胎儿,进行胎儿核型分析、详细的超声检查及其记录,由新生儿科医生、小儿外科医生和母胎医学专家组成的多学科团队为患有囊性水瘤胎儿的家庭提供遗传咨询很重要,因为存在非整倍体和胎儿畸形高风险。

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