53例早孕期胎儿水肿超声特点及妊娠结局分析  

Ultrasound features and outcome of fetuses with hydrops fetalis in the first trimester:A review of 53 cases

作　　者：黄慧 王卫云 冯倩[1] 王颖芳[1] 王念 陈欣林[1] Huang Hui;Wang Weiyun;Feng qian;Wang Yingfang;Wang Nian;Chen Xinlin(Department of Ultrasonography,Maternal and Child Health Hospital of Hubei Province,Wuhan 430000,Hubei,China)

机构地区：[1]湖北省妇幼保健院超声诊断科,湖北武汉430070

出　　处：《中国产前诊断杂志（电子版）》2022年第1期26-30,共5页Chinese Journal of Prenatal Diagnosis(Electronic Version)

基　　金：湖北省卫生计生科研基金(WJ2018H0164、WJ2018H0132);湖北省科技厅自然科学基金(2020CFB164);湖北省科技厅重点研发计划项目(2020BCB002)。

摘　　要：目的分析早孕期水肿胎儿的超声特征及妊娠结局。方法对2018年1月至2019年8月在湖北省妇幼保健院诊断为胎儿水肿的53例早孕期(11~13+6周)胎儿进行产前超声表现、染色体结果及妊娠结局进行回顾性分析。结果53例早孕期水肿胎儿中,最常见的水肿部位是胸腔(53/53,100%),其次是皮下(49/53,92.5%);出现2处胎儿体腔积液的发生率最高(44/53,83.0%)。52例(98.1%)合并其他部位或系统畸形,其中以淋巴水囊肿和心血管系统异常最为常见,分别占92.5%(49/53)和45.3%(24/53)。9例胎儿在16~18周进行了超声检查,水肿部分或完全消退4例。16例胎儿进行了核型分析,染色体非整倍体发生率为68.8%(11/16)。预后追踪结果显示,53例水肿胎儿中,宫内死亡4例(7.5%),终止妊娠例51例(96.2%),继续妊娠至分娩2例(3.8%)。结论胸腔积液和皮肤水肿是早孕期胎儿水肿常见超声特点。早孕期胎儿水肿预后较差,染色体非整倍发生率高。合并畸形种类复杂,系统超声检查有助于临床上确定病因并进行预后分析。Objective To evaluate the ultrasound characteristics and outcomes of fetuses diagnosed with hydrops fetal is in the first trimester of pregnancy.Methods A retrospective study was carried out in 53fetuses with hydrops fetal is diagnosed in the first trimester of pregnancy from January 2018to August2019.Ultrasound findings,fetal chromosome profiles and outcomes were collected and analyzed.Results Among the 53fetuses affected by non-immune hydrops fetal diagnosed in the first trimester of pregnancy,pleural effusion(53/53,100%)is the mostly identified fluid collection,followed by skin edema(49/53,92.5%).The incidence of fetuses with two abnormal fluid effusions was the highest(44/53,83.0%).52cases(98.1%)were associated with other anomalies.Among the associated anomalies,cystic hygroma and abnormality in cardiovascular system were the most commonly identified,accounting for 92.5%(49/53)and 45.3%(24/53),respectively.Among the 9cases with subsequent ultrasound examination between 16 weeks and 18 weeks of gestation,the fetal hydrops partially or completely resolved in 4cases.The results of karyotype analysis of 16fetuses were collected,and the incidence of aneuploidy was 68.8%(11/16).According to the pregnancy outcome,7.5%of cases were died in utero,96.2%of cases were terminated,and 3.8%were delivered.Conclusion Pleural effusion and skin edema are the most common identified in fetuses with hydrops fetalis in the first trimester of pregnancy.The prognosis of hydrops fetalis in this trimester is poor.Fetal hydrops diagnosed in the first trimester of gestation is associated with a higher incidence of aneuploidy.As the types of associated anomalies are complex,a detailed survey for anomalies of the fetus with hydrops fetalis by ultrasound is helpful to determine the etiology and analyze the prognosis.

关 键 词：胎儿水肿 早孕期 合并畸形 超声检查 妊娠结局 

分 类 号：R445.1[医药卫生—影像医学与核医学]