胎儿皮层形的产后后果:系统性审查
N Abadia-Cuchi1,2, F Felici1,3, P Frassanito3
1Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.
概括
由于产后数据有限,为胎儿皮层发育形 (MCD) 提供家长咨询是具有挑战性的. 这项审查发现,约三分之一患有MCD的活产婴儿表现出正常或轻度的神经发育延迟,这表明严重程度的潜在过度诊断.
科学领域:
- 神经科学是一个神经科学.
- 发展生物学 发展生物学
- 医疗成像医学成像
背景情况:
- 对胎儿皮层发育形 (MCD) 的家长咨询依赖于产后数据,这些数据可能不准确地反映出产前诊断.
- 现有的研究往往侧重于患有神经发育异常的儿童和成人,限制了对产前病例的适用性.
研究的目的:
- 审查现有的关于被诊断为皮层发育形 (MCD) 的胎儿产后神经发育结果的数据.
- 评估MCD重度产前诊断的准确性及其对神经发育结果的影响.
主要方法:
- 在PubMed,Web of Science和EMBASE进行了全面的文献搜索,搜索了2013年至2023年间发表的研究.
- 数据提取包括参与者的特征,成像发现,以及从30篇获取的文章中获取的妊娠/新生儿结果,其中包括371例胎儿MCD.
主要成果:
- 在审查的371例胎儿MCD病例中,大多数是复杂的 (n=324). 怀孕结果包括144次终止和4次死产.
- 产后神经发育数据仅用于74名活产中的30名. 23.3%的人报告正常结局,而76.7%的人表现出神经发育迟缓.
- 9例重症的产前诊断在产后被修订 (复杂到孤立的MCD),表明大约5%的已知结果的病例可能存在过度诊断.
结论:
- 大多数审查的胎儿MCD病例是复杂的,往往导致妊娠终止.
- 关于被诊断患有MCD的胎儿产后神经发育的数据显著缺乏.
- 现有数据表明,大约三分之一患有MCD的活生生的婴儿可能具有正常或轻度的神经发育结果,突出显示出潜在的产前重估严重程度.
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