阻塞性或非阻塞性巨囊:一个产前困境.
Martina Mandaletti1,2, Elisa Cerchia1, Elena Ruggiero1,3
1Pediatric Urology Unit, Department of Public Health and Pediatric Sciences, Regina Margherita Children's Hospital, Turin, Italy.
Frontiers in pediatrics
|July 17, 2024
概括
产前巨囊诊断,通常与下泌尿道阻塞 (LUTO) 相关,有85%的活产率. 目前的产前指标不能预测产后结果或功能.
科学领域:
- 周围生理学 周围生理学
- 胎儿医学 胎儿医学
- 儿科泌尿外科 儿科泌尿外科
背景情况:
- 大囊的产前诊断显著影响怀孕结果和胎儿发育.
- 区分阻塞性和非阻塞性原因对于预测产后健康至关重要.
- 对胎儿/新生儿存活率和器官功能的不良影响需要进一步研究.
研究的目的:
- 研究胎儿巨囊的自然史.
- 区分子宫内先天性下尿道阻塞 (LUTO) 和非阻塞性大囊.
- 根据产前发现预测产后结果和功能.
主要方法:
- 具有特定膀直径标准的胎儿的回顾性观察研究 (2015年7月至2023年11月).
- 包括:纵向膀直径>7mm (第一季度) 或过度扩张/加厚的膀无法排空 (2nd/3rd季度).
- 使用了超声波,基因检测,产前咨询和产后随访;根据诊断分层的患者 (LUTO,非LUTO,正常的尿路).
主要成果:
- 包括27个胎儿 (26个男性);92%的诊断是在第二和第三个季度.
- 85%的活产 (23名新生儿),有2名产后死亡是由于发育不良.
- 没有评估的产前参数 (例如,上部通道扩张,钥匙孔标志,LBD,GA) 预测产后诊断或功能.
结论:
- 第二/第三季度巨囊的诊断显示有85%的活产率,LUTO是主要原因.
- 这一结果可能比之前报告的结果更为有利,影响产前咨询.
- 大囊是一种复杂的产前症状,除/呼吸系统风险外,预后有所不同.
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