Women's Health, University College London Hospitals NHS Foundation Trust, London, UK.
Women's Health, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK.
J Ultrasound Med. 2024 Dec;43(12):2327-2337. doi: 10.1002/jum.16566. Epub 2024 Sep 9.
Evaluate pregnancy and neonatal outcomes with fetal cystic lymphatic malformations (LMs), excluding those arising from the posterior neck, to facilitate patient counseling.
A systematic review was performed in accordance with PRISMA guidance. Case series and case reports published between 2000 and 2022 were included.
Sixty-five studies (96 fetuses) met the inclusion criteria. The average gestational age at diagnosis was 25.5 weeks with the commonest location being the anterior neck (28%). All patients were diagnosed with LM using two-dimensional (2D) ultrasound. Prenatal progression in LM size, presence of intralesional bleeding, or fetal hydrops occurred in 70% (41/59), 9% (5/59), and 3% (2/59), respectively. Chromosomal and structural abnormalities were reported in 4% (2/52) and 2% (2/96), respectively. Overall livebirth rate was 94% (79/84); 12/96 resulted in termination and 5/84 in in utero demise. The average gestational age of delivery was 37.7 weeks. Exactly 19% (15/79) had a vaginal birth, of which shoulder dystocia occurred in one infant. Ex utero intrapartum treatment (EXIT) procedure was performed in 13% (10/79). Postnatal treatment commonly involved surgical excision 38% (30/79), sclerotherapy in 21.5% (17/79), or combination of both in 11.4% (9/79). Of those with reported follow-up, 4 died within 1 year, 1 developed heart failure at 2 years of life, and the remaining 44 had normal developmental outcomes.
Fetal cystic LMs, excluding those in the posterior neck, are not commonly associated with chromosomal, or additional structural abnormalities. They usually increase in size before delivery with only a minority developing complications. The good developmental outcome was reported in all survivors.
评估胎儿囊性淋巴管畸形（LM）的妊娠和新生儿结局，不包括源于颈后部位的 LM，以方便患者咨询。
按照 PRISMA 指南进行系统综述。纳入 2000 年至 2022 年期间发表的病例系列研究和病例报告。
65 项研究（96 例胎儿）符合纳入标准。平均诊断孕周为 25.5 周，最常见的部位是颈前（28%）。所有患者均通过二维（2D）超声诊断为 LM。70%（41/59）、9%（5/59）和 3%（2/59）的患者分别出现 LM 大小进行性增大、瘤内出血和胎儿水肿。4%（2/52）和 2%（2/96）的患者分别报告存在染色体和结构异常。总活产率为 94%（79/84）；12/96 例患者终止妊娠，5/84 例患者胎儿宫内死亡。平均分娩孕周为 37.7 周。79 例活产儿中有 19%（15/79）经阴道分娩，其中 1 例发生肩难产。13%（10/79）例患者行子宫外产时治疗（EXIT）术。产后治疗常采用手术切除 38%（30/79）、硬化治疗 21.5%（17/79）或两者联合 11.4%（9/79）。有随访报道的患者中，4 例在 1 年内死亡，1 例在 2 岁时发生心力衰竭，其余 44 例发育正常。
不包括颈后部位的胎儿囊性 LM 通常不伴有染色体或其他结构异常。它们在分娩前通常会增大，只有少数会出现并发症。所有幸存者的发育结局良好。
