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在产前检测到的胸部病变:预后,管理和结果

Md Mokarram Ali¹, Nilesh Tank², Monika Bawa³

¹Department of Pediatric Surgery, PGIMS, Rohtak, Haryana, India.

African journal of paediatric surgery : AJPS

|March 28, 2024

概括

产前胸部病变,如CPAM,CDH和BPS不常见,但需要监测. 预后受到CVR和LHR的影响,指导管理和改善结果.

科学领域:

产周医学产周医学
胎儿医学是关于胎儿的医学.
儿科外科手术儿科外科手术

背景情况:

胎儿胸部病变很罕见,大约发生在1万5千个活产中的1例中.
产前检测和监测对于家长咨询和新生儿福祉至关重要.
常见的病变包括先天性肺腺形形 (CPAM),先天性隔膜 (CDH) 和支气管肺结节 (BPS).

研究的目的:

为了调查胎儿胸部病变的预后和结果,在产前检测到.
评估诸如先天性囊性腺瘤形 (CCAM) 体积比 (CVR) 和肺对头比 (LHR) 等参数在确定结果中的作用.
为家长咨询提供有关产后管理和预后的见解.

主要方法:

在2年内进行的前性研究 (2017年1月 - 2018年12月).
包括怀孕女性,胎儿胸部病变通过第二/第三个月的超声波和胎儿MRI诊断.
评估CVR和LHR,并分析结果,包括妊娠终止,胎儿/新生儿死亡以及手术或保守管理.

主要成果:

在521例怀孕中,有22例 (4.22%) 检测到胸部病变.
CPAM的发病率为45.45%,BPS为22.73%,CDH为22.73%,先天性上呼吸道阻塞为9.1%.
结果包括13.64%的终止,18.2%的产后死亡和CDH和BPS的不同手术干预;45.45%的治疗方法是保守的,在2年的随访中获得良好结果.

结论:

CPAM,BPS和CDH是最常见的产前胸部病变.
超声波和MRI对于检测和预后至关重要.
CVR,LHR和相关的形是关键的预后标志物,需要对自然史进行长期研究.

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