ハイポプラスティック左心症候群の産前診断後の結果:ケースシリーズ
K J Brackley1, M D Kilby, J G Wright
1Division of Reproductive and Child Health, Birmingham Women's and Children's Hospitals, University of Birmingham.
Lancet (London, England)
|October 13, 2000
まとめ
ハイポプラスティック左心症候群 (HLHS) の産前診断は,親の意思決定に影響します. 胎児エコーカルディオグラフィによる早期発見は,HLHSの管理に役立ちますが,生存率は,影響を受けた家族にとって重要な懸念事項です.
科学分野:
- 心臓病学 心臓病学
- 産前診断 産前診断
- 生まれながらの心臓病 生まれながらの心臓病
背景:
- ハイポプラスティック左心症候群 (HLHS) の診断は,伝統的に終了または快適なケアにつながります.
- ノルウッド手術のような産後手術の選択肢は,最大60%の生存率を提供します.
- 産前と産後のHLHS診断に基づく生存率の違いについては,不確実性があります.
研究 の 目的:
- HLHSと診断された胎児の生存率を評価する.
- 産前発見が経営決定と成果に与える影響を評価する.
- HLHSに関する親のカウンセリングのための最新のデータを提供するために.
主な方法:
- 産前診断された87例のHLHS症例の遡及的レビュー.
- バーミンガム婦人病院胎児医学部 (1994年~1999年) のデータを分析した.
- 産前カリオタイピング,関連する異常評価,産後外科的アウトカムを含む.
主要な成果:
- 産前診断されたHLHSの全生存率は25% (終末を除く).
- 産後手術を受けた赤ちゃんの生存率は33% (36人中12人) であった.
- 12%の症例は異常なカリオタイプがあり,21%は関連する構造的異常があった.
結論:
- 胎児エコーカルディオグラフィは,HLHSの早期診断とリスクの階層化を可能にします.
- カリオタイピングを含む産前発見は,臨床的意思決定に役立ちます.
- 将来のデータは,HLHS管理に関する親の知的な選択をサポートします.
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