Bromley B, Benacerraf B R
Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts.
J Ultrasound Med. 1994 Jul;13(7):529-33. doi: 10.7863/jum.1994.13.7.529.
The purpose of this study was to evaluate the spectrum of sonographic findings, karyotypic abnormalities, and clinical outcome in cases of fetal micrognathia. Twenty fetuses with sonographically identified micrognathia were identified between 15 weeks' gestation and term. Five of 20 fetuses (25%) had abnormal karyotypes, including three with trisomy 18 and one each with trisomy 13 and trisomy 9. Sixteen of the 20 fetuses (80%) did not survive: Ten died in utero or during the neonatal period, and six pregnancies were terminated electively. Three of 20 fetuses (15%) had micrognathia as the sole sonographic finding. Two of these fetuses survived, one with growth retardation and one with Pierre Robin syndrome. Thirteen of 20 pregnancies were complicated by polyhydramnios. The diversity of the syndromes represented in our cases of micrognathia indicates a wide breadth of possible diagnoses when micrognathia is encountered prenatally. The poor prognosis and associated karyotypic and lethal anomalies are remarkable, with survival of only four of 20 fetuses in this report.
本研究的目的是评估胎儿小下颌病例的超声检查结果、核型异常及临床结局。在妊娠15周与足月之间,共识别出20例经超声检查确诊为小下颌的胎儿。20例胎儿中有5例(25%)核型异常,其中3例为18三体,1例为13三体,1例为9三体。20例胎儿中有16例(80%)未能存活:10例在子宫内或新生儿期死亡,6例妊娠被选择性终止。20例胎儿中有3例(15%)超声检查仅发现小下颌。其中2例存活,1例有生长发育迟缓,1例患有皮埃尔·罗宾综合征。20例妊娠中有13例并发羊水过多。我们小下颌病例所代表的综合征多样性表明,产前遇到小下颌时可能的诊断范围很广。预后不良以及相关的核型和致死性异常很显著,本报告中20例胎儿仅4例存活。