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皮埃尔·罗宾序列征的产前诊断及其预后:一项回顾性队列研究

Prenatal Diagnosis of Pierre Robin Sequence and Its Prognosis: A Retrospective Cohort Study.

作者信息

Zhong ChunYan, Xie Zhaopeng, Dong Hongmei, Chen Ting, Zhang Xiaohang, Ran SuZhen

机构信息

Department of Ultrasound, Chongqing Health Center for Women and Children, Chongqing, People's Republic of China.

Department of Ultrasound, Women and Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.

出版信息

Am J Perinatol. 2024 May;41(S 01):e1639-e1646. doi: 10.1055/s-0043-1768233. Epub 2023 Apr 17.

Abstract

OBJECTIVE

This study aimed to explore the efficiency of ultrasound (US) in prenatal diagnosis and prognosis of Pierre Robin sequence (PRS) of 18 cases.

STUDY DESIGN

A total of 79,305 women admitted for prenatal US examinations were recruited from January 2017 to December 2020. Eighteen cases of PRS fetuses were selected form the cohort and 40 cases of isolated micrognathia were recruited randomly as control group. All the clinical and imaging results were retrospectively reviewed. General condition, US measurements, and prognosis of fetuses were compared between groups.

RESULTS

Cleft palate, glossoptosis, and micrognathia were found in all 18 fetuses with PRS by prenatal US. Compared with the isolated micrognathia group, there were no significant differences in the PRS group in examination of maternal age, gestational weeks at assessment, and gender of fetuses, but significant lower measures in inferior facial angle, jaw index, and frontal nasal-mental angle (each  < 0.05). Twelve fetuses were defined to have other associated malformations. Ear malformations were the most common associated malformations with a prevalence of 44.4% (8/18). All of the18 cases were confirmed with PRS after delivery or autopsy. Two delivered infants were found bucking easily, one baby was spitting up frequently but growth showed normal.

CONCLUSION

Prenatal detection of PRS with US examination is highly efficient. Even with the triad of malformations, isolated PRS had good outcomes following initial stabilization and management in the neonatal period. Prenatal detection of Pierre Robin syndrome with targeted US examination is efficient in discerning characteristics of this rare syndrome. Even with the triad of malformations, isolated PRS had good outcomes following initial stabilization and management in the neonatal period.

KEY POINTS

· Prenatal diagnosis of fetal PRS is of great clinical importance.. · Micrognathia has been identified as the primary feature of PRS.. · Posterior displacement of the tongue may cause acute neonatal respiratory distress.. · Even with triad malformation, isolated PRS seemed to have good outcomes..

摘要

目的

本研究旨在探讨超声(US)在18例皮埃尔·罗宾序列征(PRS)产前诊断及预后评估中的效能。

研究设计

选取2017年1月至2020年12月期间因产前超声检查入院的79305例孕妇。从该队列中选出18例PRS胎儿,并随机选取40例单纯小颌畸形胎儿作为对照组。对所有临床及影像学结果进行回顾性分析。比较两组胎儿的一般情况、超声测量结果及预后。

结果

产前超声检查发现,18例PRS胎儿均有腭裂、舌后坠及小颌畸形。与单纯小颌畸形组相比,PRS组孕妇年龄、评估时孕周及胎儿性别检查方面无显著差异,但下颌下角度、下颌指数及额鼻颏角测量值显著更低(均P<0.05)。12例胎儿被确定有其他合并畸形。耳部畸形是最常见的合并畸形,患病率为44.4%(8/18)。18例均在分娩或尸检后确诊为PRS。2例分娩婴儿易出现呛咳,1例婴儿频繁吐奶,但生长发育正常。

结论

超声检查对PRS进行产前诊断效率很高。即使存在三联畸形,孤立性PRS在新生儿期经过初始稳定治疗和管理后预后良好。针对性超声检查对产前诊断皮埃尔·罗宾综合征有效,可识别这种罕见综合征的特征。即使存在三联畸形,孤立性PRS在新生儿期经过初始稳定治疗和管理后预后良好。

要点

·胎儿PRS的产前诊断具有重要临床意义。·小颌畸形已被确定为PRS的主要特征。·舌后移可能导致新生儿急性呼吸窘迫。·即使存在三联畸形,孤立性PRS似乎预后良好。

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