胎儿腹水的超声诊断及临床转归  

Ultrasonic Diagnosis and Clinical Outcome of Fetal Ascites

作　　者：康文 裴秋艳[2] Kang Wen;Pei Qiuyan(Chengdu Women′s and Children′s Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu,Sichuan 611731,China;Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院-成都市妇女儿童中心医院,成都市611731 [2]北京大学人民医院产科

出　　处：《中国超声医学杂志》2020年第10期920-922,共3页Chinese Journal of Ultrasound in Medicine

基　　金：首都卫生发展科研专项(No.2018-2-4083)。

摘　　要：目的分析胎儿腹水的常见发病原因及临床转归。方法回顾性分析我院就诊或自外院转入的超声诊断为胎儿腹水的临床转归资料,并收集相关发病原因。结果46例胎儿腹水病例中,31例为单纯性腹水,15例合并其他部位水肿。导致胎儿腹水的前4位原因是15例为TORCH感染,10例为RH血型不合,5例为胎粪性腹膜炎,3例为胎儿心律失常,各自的胎儿活产率分别为93%、10%、100%和100%,少见原因为孕妇B19细小病毒感染、胎儿染色体异常、胎儿心脏畸形各2例,胎盘绒毛膜羊膜炎、孕妇抗磷脂综合征、胎儿非免疫性贫血各1例,4例病因不明。26例足月出生和4例提早剖腹产,胎儿腹水均在分娩前消失或明显减少;9例胎死宫内和7例引产,胎儿腹水增多或无明显改变。结论产前超声检查能明确诊断胎儿腹水,通过追踪腹水量的变化,结合发病原因,有助于产前咨询,改善预后。Objective To analyze the common causes and clinical outcomes of fetal ascites.Methods Retrospective analysis of Peking University People′s Hospital from ultrasound diagnosis of fetal ascites clinical data,and to collect the relevant causes.Results Among 46 cases of fetal ascites,31 cases were simple ascites and 15 cases were complicated with edema in other parts.The top four causes of fetal ascites were TORCH infection in 15 cases,Rh blood group incompatibility in 10 cases,meconium peritonitis in 5 cases and fetal arrhythmia in 3 cases.The live birth rates of each group were 93%,10%,100%and 100%,respectively,The rare causes were maternal B19 parvovirus infection,fetal chromosomal abnormalities,fetal heart malformation in 2 cases,placental chorioamnionitis,pregnant woman antiphospholipid syndrome,fetal non immune anemia in 1 case,4 cases of unknown etiology.In 26 cases of full-term birth and 4 cases of early cesarean section,fetal ascites disappeared or decreased significantly before delivery;in 9 cases of fetal death and 7 cases of induced labor,fetal ascites increased or remained unchanged.Conclusions Prenatal ultrasound can clearly diagnose fetal ascites.By tracking the change of ascites volume and combining with the causes of the disease,it is helpful to prenatal consultation and improve the prognosis.

关 键 词：胎儿腹水 超声诊断 发病原因 临床转归 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]