51例胎儿肠管增宽妊娠结局分析  

Pregnancy outcome analysis of 51 cases of fetal bowel dilatation

作　　者：边欣怡 曹婧[1] 柳宛璐 石鑫玮[1] 龚洵 刘海意 乔福元[1] 冯玲 吴媛媛 Bian Xinyi;Cao Jing;Liu Wanlu(Department of Obstetrics and Gynecology,Tongji Hospital,Tongji Medical College,Huazhong University of Science & Technology,Wuhan 430030)

机构地区：[1]华中科技大学同济医学院附属同济医院妇产科,武汉430030

出　　处：《现代妇产科进展》2020年第9期652-655,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨胎儿肠管增宽的临床表现与妊娠结局之间的相关性,为临床咨询、判断预后和指导治疗提供依据。方法:回顾分析2015年10月至2019年6月于华中科技大学附属同济医院胎儿系统超声诊断为肠管增宽的51例孕妇的临床资料。结果:51例孕妇中,19例妊娠结局良好,32例出现不良妊娠结局(引产、胎死宫内、新生儿死亡、出生后需手术治疗等),占62.7%。胎儿十二指肠增宽的不良结局发生率为100%,明显高于小肠增宽(54.2%)及结直肠增宽(25.0%)。孕32周前诊断胎儿肠管增宽不良妊娠结局发生率为72.7%,而孕32周后检出者为44.4%。胎儿肠管增宽合并羊水过多22例,不良结局发生率为86.4%,明显高于羊水量正常孕妇(40.0%)。10例孕妇行羊膜腔穿刺产前诊断均未发现异常,2例十二指肠增宽新生儿行基因检查为21-三体综合征。结论:产前超声诊断胎儿肠管增宽与消化系统畸形及妊娠结局密切相关,及时发现、密切随访、早期处理极为重要。Objective:To explore the correlation between fetal bowel dilatation and pregnancy outcomes,and to provide basis for clinical consultation,prognosis and treatment.Methods:51 fetuses who were diagnosed as fetal bowel dilatation by prenatal ultrasound from October 2015 to June 2019 in Tongji Hospital were enrolled and analyzed.Results:Among the 51 cases,the prognosis of 19 patients was good,and 32 neonates were diagnosed with abnormalities,including labor,intrauterine fetal death,neonatal death and surgical treatment.The incidence of adverse outcomes of duodenum dilatation was 100%,which was significantly higher than that of jejunum and ileum dilatation(54.2%)and colorectal dilatation(25.0%).The incidence of adverse pregnancy outcomes was 72.7%before 32 weeks and 44.4%after 32 weeks.The incidence of adverse outcome was 86.4%in 22 cases with polyhydramnios,which was higher than 40.0%in those with normal amniotic fluid volume.Chromosome abnormality was found in 2 cases of duodenum dilatation.Conclusions:Prenatal diagnosis of fetal bowel dilatation is closely related to digestive system malformation and pregnancy outcomes,which should be given appropriate treatment.

关 键 词：胎儿 肠管增宽 妊娠结局 肠梗阻 

分 类 号：R714[医药卫生—妇产科学]