怀孕年龄较小的胎儿在第二个三个月被诊断出:可能的病因和短期新生儿结果
Lucia Pasquini1, Giulia Masini1, Greta Cagninelli2,3
1Fetal Medicine Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Acta obstetricia et gynecologica Scandinavica
|September 19, 2023
概括
在26周之前早期诊断胎儿生长限制 (<第10个百分点) 往往表明潜在的问题,其中27%不是孤立的. 这凸显了需要进行详细的扫描和遗传咨询,以获得更好的妊娠结果.
科学领域:
- 周围生理学 周围生理学
- 胎儿医学 胎儿医学
- 遗传学 是一个遗传学.
背景情况:
- 在妊娠26周之前诊断的胎儿生长限制 (FGR) 是单子怀孕的一个重大问题.
- 了解早期FGR的病因对于预测妊娠结果和指导临床管理至关重要.
研究的目的:
- 调查妊娠26周之前诊断的胎儿生长限制 (<第10百分位) 的原因.
- 根据早期发病FGR的鉴定病因,比较怀孕结果.
主要方法:
- 历史上的队列研究,包括435名被诊断患有FGR的胎儿在妊娠18至26周之间.
- 胎儿分为三组:染色体异常,发育不良和孤立的FGR.
- 怀孕结果在不同组之间进行了比较,进一步分析了隔离组内小到妊娠年龄的FGR与FGR.
主要成果:
- 在435个胎儿中,4.6%的胎儿有染色体异常,22.5%的胎儿有形,72.9%的胎儿是孤立的.
- 孤立的FGR病例 (3组) 的活产率更高 (P < 0.001).
- 与受孕年龄小的胎儿相比,生长受限的胎儿表现较差,包括分娩时更低的妊娠年龄,出生体重,以及更高的终止率和子宫内死亡率.
结论:
- 早期发病的FGR经常与潜在的染色体异常或形有关 (27%的病例).
- 对于疑似早期发作的FGR,建议进行详细的异常扫描和侵入性测试.
- 即使进行正常的产前检测,也存在残留的不良结果风险,包括新生儿死亡和遗传综合征或神经发育障碍的产后诊断.
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