专家共识关于胎儿腹腔大:对23个关键临床问题的基于证据的建议
Xin Li1,2, Ting Hu1,2, Xue Xiao2,3
1Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Frontiers in pediatrics
|November 3, 2025
概括
胎儿腹腔巨变 (VM) 是一种常见的大脑异常. 这种共识为其诊断,管理和预后提供了基于证据的建议,旨在实现标准化护理和改善结果.
科学领域:
- 在产前成像和诊断.
- 胎儿神经学 胎儿神经学
- 医学共识和指导方针
背景情况:
- 胎儿腹腔巨变 (VM),心脏直径≥10毫米,是通过产前成像检测到的频繁的中枢神经系统异常.
- 对于胎儿VM的现有诊断和管理方法表现出不一致.
- 这种专家共识通过提供分级的,基于证据的建议来解决这些差距.
研究的目的:
- 建立标准化,基于证据的建议,用于产前诊断和管理胎儿心室壮病 (VM).
- 在包括诊断,病因学,评估,产前管理,分娩和预后在内的关键领域提供指导.
- 为了解决胎儿VM当前临床实践中的不一致性.
主要方法:
- 一个多学科小组使用了经过修改的Delphi方法来制定23个临床问题.
- 专家咨询,结构化问卷和共识建设涉及产科,成像学,遗传学,新生儿学,神经学和其他领域的专家.
- 根据国际指导方针,队列研究,元分析,并使用修改后的GRADE框架对建议进行分级.
主要成果:
- 建议标准化使用超声波和胎儿MRI进行诊断.
- 建议对所有VM病例进行染色体微阵列 (CMA),无论隔离状态如何.
- 重点是个性化监测,考虑心室进展,以及高风险病例的结构化神经发育随访. 动态成像,母性因素和多omics工具可能有助于风险分层.
结论:
- 这种共识建立了对胎儿VM管理的全面,结构化的方法.
- 它促进了标准化的临床实践和早期识别高风险胎儿.
- 鼓励对预后系统,长期结果和病因途径进行未来的研究.
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