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产前诊断胎儿半椎体的长期预后:一项15年单中心回顾性研究

Long-Term Outcomes of Prenatally Diagnosed Fetal Hemivertebra: A 15-Year Single-Center Review.

作者信息

Costas Tatiana, Rodríguez María de la O, Martín Esquilas María, Alarcón Verónica, Goenaga Francisco Javier, Cabrero María Ángeles, Cubo Ana María

机构信息

Department of Obstetrics and Gynecology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain.

Faculty of Medicine, University of Salamanca (USAL), 37007 Salamanca, Spain.

出版信息

Children (Basel). 2025 Sep 16;12(9):1236. doi: 10.3390/children12091236.

Abstract

BACKGROUND/OBJECTIVES: The primary aim of this study was to describe all cases of fetal hemivertebrae diagnosed prenatally at the Hospital Clínico Universitario de Salamanca over the last 15 years. Additionally, the presence of associated malformations was assessed, pregnancy outcomes were evaluated, and child development results were analyzed in affected cases.

METHODS

We undertook a prospective observational analysis of all cases (N = 10) of prenatally diagnosed hemivertebrae at our hospital between 2007 and 2022. Postnatal follow-up was performed through telephone interviews and reviewing medical records.

RESULTS

Most cases were diagnosed during the second-trimester ultrasound, with the lumbar region being the most frequently affected site (60%). Multiple hemivertebrae were detected in 4 of 10 cases. One case of Marfan syndrome and two cases of VACTERL association (vertebral defects, anal atresia, tracheoesophageal fistula, renal dysplasia, and limb abnormalities) were documented. Six cases presented with additional malformations. Cases involving multiple hemivertebrae (40%) were more likely to be associated with other anomalies and poorer prognoses, while isolated single hemivertebra showed favorable outcomes, with normal development during childhood. Vaginal delivery occurred in six cases, while cesarean sections were performed for standard obstetric indications unrelated to the hemivertebra diagnosis.

CONCLUSIONS

Prenatal diagnosis of hemivertebra is achievable and holds critical neonatal and postnatal relevance. Hemivertebrae are often linked to additional disorders, including genetic syndromes, and carry significant prognostic implications depending on the associated anomalies and the extent of vertebral involvement.

摘要

背景/目的:本研究的主要目的是描述过去15年在萨拉曼卡大学临床医院产前诊断出的所有胎儿半椎体病例。此外,评估相关畸形的存在情况,评价妊娠结局,并分析受累病例的儿童发育结果。

方法

我们对2007年至2022年期间在我院产前诊断为半椎体的所有病例(N = 10)进行了前瞻性观察分析。通过电话访谈和查阅病历进行产后随访。

结果

大多数病例在孕中期超声检查时被诊断出来,腰椎区域是最常受累的部位(60%)。10例中有4例检测到多个半椎体。记录了1例马凡综合征和2例VACTERL联合征(椎体缺陷、肛门闭锁、气管食管瘘、肾发育不良和肢体异常)。6例出现其他畸形。涉及多个半椎体的病例(40%)更有可能伴有其他异常且预后较差,而孤立的单个半椎体显示出良好的结局,儿童期发育正常。6例经阴道分娩,剖宫产是因与半椎体诊断无关的标准产科指征而进行的。

结论

半椎体的产前诊断是可行的,对新生儿和产后具有关键意义。半椎体常与其他疾病相关,包括遗传综合征,并根据相关异常情况和椎体受累程度具有重要的预后意义。

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