在子宫内进行治疗
Ingo Gottschalk1, Eva Christin Weber1, Ivonne Bedei2
1Department of Obstetrics and Gynecology, Division of Prenatal Medicine, Gynecological Sonography and Fetal Surgery, University of Cologne, Köln, Germany.
概括
产前干预已经取得了重大进展,但存在风险. 本综述涵盖了胎儿在子宫内可治疗的疾病,以及支持这些子宫内疗法的证据.
科学领域:
- 医学科学 医学科学 医学科学
- 胎儿医学 胎儿医学
- 手术创新 在外科创新.
背景情况:
- 自20世纪70年代以来,子宫内干预已经发展,在专门中心的频率增加.
- 尽管有进展,但产前手术对胎儿和母亲都有很大的风险.
- 干预通常是为危及生命的胎儿疾病保留的,如果不治疗,胎儿产后预后不好.
研究的目的:
- 为提供适合宫内治疗的胎儿状况的概述.
- 审查支持各种产前干预措施的证据.
- 要突出临床试验中严格评估的干预措施的数量有限.
主要方法:
- 审查关于子宫内干预的现有文献.
- 对特定胎儿疾病和治疗方法的证据分析.
- 通过受控试验确定具有已确定的疗效的条件.
主要成果:
- 产前干预的范围和应用已经大大扩大.
- 支持产前干预的受控临床试验仍然有限.
- 已确立的成功干预措施包括治疗胎儿输血综合征的激光疗法,脊柱裂关闭,以及对先天性隔膜的气管封闭.
结论:
- 由于子宫内干预的固有风险,仔细选择患者至关重要.
- 需要进一步的研究和受控试验来验证更多的产前疗法.
- 激光疗法,脊柱裂修复和气管封闭是成功宫内干预的关键领域.
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