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目的分析单纯性轻度侧脑室扩张(isolated mild ventriculomegaly,IMV)胎儿的宫内转归及其预后。方法前瞻性选择进行常规产前检查的12324例单胎孕妇,自妊娠20周始,测量胎儿侧脑室后角宽度(代表侧脑室宽度),将发现的IMV112例作为研究对象,以同期检查胎儿无侧脑室扩张的健康孕妇224例作为对照组,对比2组一般资料,并动态观察IMV胎儿的宫内转归与预后情况。结果 IMV的发生率为0.91%(112/12324)。IMV孕妇的平均年龄高于健康孕妇(P<0.05)。宫内转归情况:进展11.3%(12/106),稳定32.1%(34/106),缩小10.4%(11/106),消失为46.2%(49/106);IMV胎儿转归的ROC曲线下面积为0.756,12mm为界定值。82例分娩获随访的患儿中发生神经行为异常4例,神经行为发育异常发生率在侧脑室宽度≥12mm者高于<12mm者(15.0%vs1.6%,P<0.05),在侧脑室扩张宫内有进展者高于无进展者(20.0%vs2.8%,P<0.05)。结论绝大部分的IMV预后良好,应高度重视对宫内进展、侧脑室宽度≥12mm者的随访。
Objective To analyze the intrauterine metastasis and prognosis of isolated mild ventriculomegaly (IMV) fetuses. Methods 12324 singleton pregnancies who underwent prenatal screening were prospectively selected. From the first trimester of pregnancy, the width of posterior horn of lateral ventricle (representing the width of lateral ventricle) was measured. One hundred and twelve cases of IMV were found to be examined in the same period 224 healthy pregnant women with lateral ventricle dilation were used as control group. The general data of two groups were compared and the intrauterine metastasis and prognosis of IMV fetus were dynamically observed. Results The incidence of IMV was 0.91% (112/12324). The mean age of IMV pregnant women was higher than that of healthy pregnant women (P <0.05). Intrauterine metastasis: progress 11.3% (12/106), stable 32.1% (34/106), reduced 10.4% (11/106), disappeared 46.2% (49/106); ROC curve fetus outcome of IMV Under the area of 0.756, 12mm for the definition. Neurological behavioral abnormalities occurred in 82 infants with follow-up of delivery. The incidence of neurobehavioral abnormalities was higher in patients with lateral ventricles ≥ 12 mm (<15.0% vs 1.6%, P <0.05) Those who had intrauterine growth were higher than those without progression (20.0% vs 2.8%, P <0.05). Conclusions The majority of patients with IMV have a good prognosis. Follow-up to intrauterine progression and lateral ventricle width ≥12 mm should be given high priority.