中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2011年
10期
608-611
,共4页
脐动脉%先天畸形%染色体畸变%妊娠结局%核型分析
臍動脈%先天畸形%染色體畸變%妊娠結跼%覈型分析
제동맥%선천기형%염색체기변%임신결국%핵형분석
Umbilical arteries%Congenital abnormalities%Chromosome aberrations%Pregnancy outcome%Karyotyping
目的 探讨与单脐动脉并发的其他胎儿畸形及妊娠结局,为孕期咨询和处理提供依据.方法 对2007年9月至2009年7月之间在本院诊断并分娩的92例单脐动脉胎儿的结局进行回顾分析及随访.结果 25292例分娩的孕妇中确诊单脐动脉共92例,发生率为0.36％,其中53例(57.6％)新生儿无畸形存活,14例(15.2％)带畸形生存,围产儿死亡25例(27.2％).92例单脐动脉胎儿中伴畸形者共36例(39.1％),其中单发畸形29例(占80.6％),多发畸形7例(占19.4％).心脏畸形发生率位居首位,其他畸形依次为中枢神经系统、消化系统、运动系统及泌尿系统的畸形.单脐动脉孕妇同意选择胎儿染色体检查共33例,其中3例有染色体畸形(9.1％).92例中伴发小于胎龄儿者23例(25.0％),其中78.3％(18/23)的小于胎龄儿死亡,明显高于同期非单脐动脉小于胎龄儿的病死率4.0％ (24/597)(x2=181.71,P＜0.01).结论 单脐动脉易伴发其他先天畸形,孕期B超发现单脐动脉后,需要进一步寻查其他畸形,进行胎儿超声心动、胎儿染色体核型分析等检查,伴发严重胎儿生长受限,是胎儿不良结局的重要指标.
目的 探討與單臍動脈併髮的其他胎兒畸形及妊娠結跼,為孕期咨詢和處理提供依據.方法 對2007年9月至2009年7月之間在本院診斷併分娩的92例單臍動脈胎兒的結跼進行迴顧分析及隨訪.結果 25292例分娩的孕婦中確診單臍動脈共92例,髮生率為0.36％,其中53例(57.6％)新生兒無畸形存活,14例(15.2％)帶畸形生存,圍產兒死亡25例(27.2％).92例單臍動脈胎兒中伴畸形者共36例(39.1％),其中單髮畸形29例(佔80.6％),多髮畸形7例(佔19.4％).心髒畸形髮生率位居首位,其他畸形依次為中樞神經繫統、消化繫統、運動繫統及泌尿繫統的畸形.單臍動脈孕婦同意選擇胎兒染色體檢查共33例,其中3例有染色體畸形(9.1％).92例中伴髮小于胎齡兒者23例(25.0％),其中78.3％(18/23)的小于胎齡兒死亡,明顯高于同期非單臍動脈小于胎齡兒的病死率4.0％ (24/597)(x2=181.71,P＜0.01).結論 單臍動脈易伴髮其他先天畸形,孕期B超髮現單臍動脈後,需要進一步尋查其他畸形,進行胎兒超聲心動、胎兒染色體覈型分析等檢查,伴髮嚴重胎兒生長受限,是胎兒不良結跼的重要指標.
목적 탐토여단제동맥병발적기타태인기형급임신결국,위잉기자순화처리제공의거.방법 대2007년9월지2009년7월지간재본원진단병분면적92례단제동맥태인적결국진행회고분석급수방.결과 25292례분면적잉부중학진단제동맥공92례,발생솔위0.36％,기중53례(57.6％)신생인무기형존활,14례(15.2％)대기형생존,위산인사망25례(27.2％).92례단제동맥태인중반기형자공36례(39.1％),기중단발기형29례(점80.6％),다발기형7례(점19.4％).심장기형발생솔위거수위,기타기형의차위중추신경계통、소화계통、운동계통급비뇨계통적기형.단제동맥잉부동의선택태인염색체검사공33례,기중3례유염색체기형(9.1％).92례중반발소우태령인자23례(25.0％),기중78.3％(18/23)적소우태령인사망,명현고우동기비단제동맥소우태령인적병사솔4.0％ (24/597)(x2=181.71,P＜0.01).결론 단제동맥역반발기타선천기형,잉기B초발현단제동맥후,수요진일보심사기타기형,진행태인초성심동、태인염색체핵형분석등검사,반발엄중태인생장수한,시태인불량결국적중요지표.
Objective To explore the relation between single umbilical artery with other malformations and pregnancy outcome,and to provide evidence for pregnancy counseling and diagnosis.Methods The outcomes of 92 fetuses with single umbilical artery diagnosed and delivered in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from September 2007 to July 2009 were followed up and retrospectively analyzed with Chi-square test.Results Among 25 292 pregnant women,92 cases were finally diagnosed as single umbilical artery giving the incidence of 0.36％,among which 57.6％ (53/92) of newborns survived without malformations,15.2％(14/92) survived with malformations and 27.2％ (25/92) died during perinatal period.There were 36 fetuses (39.1％,36/92) with single umbilical artery complicated with other malformations,among which 29 had single malformation (80.6 ％ ),and seven ( 19.4 ％ ) had multiple malformations.The incidence of heart defects was the highest among the complicated malformations,and then followed by central nervous system,digestive system,motor system and urinary system.Thirty-three fetuses with single umbilical artery accepted karyotype analysis.Chromosome abnormality was diagnosed in three subjects (9.1％,3/33).Twenty-three fetus (25.0％,23/92) associated with small for gestational age,and among which 18 fetuses (78.3％,18/23) died with a higher mortality than that (4.0％,24/597) of small for gestational age patients without single umbilical artery (x2=181.71,P＜0.01).Conclusions Single umbilical artery is likely to be complicated with congenital anomalies.After single umbilical artery was diagnosed by routine ultrasound,fetal ultrasonography,echocardiography and amniocentesis for karyotype analysis is suggested.Fetal growth restriction is an important indicator of fetal adverse outcomes.
