33例非免疫性胎儿水肿临床特点与妊娠结局  

Clinical Characteristics and Pregnancy Outcome of 33 Cases of Nonimmune Hydrops Fetalis

作　　者：王学举[1] 于海燕[2] 魏瑗[1] 原鹏波[1] 赵扬玉[1] 

机构地区：[1]北京大学第三医院,北京100191 [2]山东省济宁市中区妇幼保健院,山东济宁272000

出　　处：《实用妇产科杂志》2015年第10期748-752,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨非免疫性胎儿水肿的病因、超声特点及妊娠结局。方法:对北京大学第三医院产科于2010年1月至2014年6月收治的33例非免疫性胎儿水肿的临床资料进行回顾分析,随访其妊娠结局。结果:33例均经超声诊断,典型胎儿水肿综合征12例,单纯性皮肤水肿17例,单纯性胸腔积液3例,单纯性腹腔积液1例。发病原因中,宫内感染占42.42%(14/33),染色体异常占21.21%(7/33),双胎输血综合征占15.15%(5/33),合并其他系统畸形占12.12%(4/33)。4例胎死宫内,19例选择放弃胎儿引产,10例继续妊娠,严格产前检查至分娩,其中2例新生儿死亡,8例存活。结论:非免疫性胎儿水肿主要表现为单纯性皮肤水肿。宫内感染和染色体异常是导致非免疫性胎儿水肿的主要病因。出现非免疫性胎儿水肿的孕妇,尽早明确病因,对临床早期干预及胎儿预后具有重要意义。Objective：To investigate the etiology,ultrasound characteristics and pregnancy outcome of nonimmune hydropsfetalis.Methods：The clinical data of 33 pregnant women who were diagnosed as nonimmune hydrops fetalis in Peking University Third Hospital from January 1st 2010 to June 1st 2014 were analyzed retrospectively.And the pregnancy outcome of the cases were followed up.Results：All the 33 cases of nonimmune hydrops fetalis were diagnosed with ultrasound during pregnancy,including 12 cases of classical hydrops fetalis（schiridde syndrome）,17 cases of hydroderma,3cases of hydrothorax and 1case of hydroperitoneum.The etiology of 33 cases of nonimmune hydrops fetalis included intrauterine infection42.42%（14/33）,chromosome abnormality 21.21%（7/33）,twin to twin transfusion syndrome15.15%（5/33）and multiple system malformation.In the 33 cases,4cases suffered fetal death in uterus,19 cases chosen abortion at second trimester,10 cases persisted pregnancy till delivery with close follow-up.In the 10 cases mentioned above,there were 8cases of neonates survived and 2cases of neonatal death.Conclusions：The main ultrasound sign of nonimmune hydrops fetalis is hydroderma.And intrauterine infection and chromosome abnormality maybe the primary causes of nonimmune hydrops fetalis.Systematical examination to identify the etiology of nonimmune hydrops fetalis at first visit may provide an opportunity to early intervention for these patients,which could improve the prognosis of hydrops fetalis.

关 键 词：胎儿水肿 产前诊断 宫内感染 妊娠结局 

分 类 号：R714.5[医药卫生—妇产科学]