摘要
目的探讨非免疫性胎儿水肿(NIHF)的病因、病理学特征、预后及临床结局。方法选择2003年1月至2012年12月于北京市海淀区妇幼保健院病理科因NIHF行尸体解剖者40例及NIHF存活者1例的胎盘为研究对象,回顾性分析其临床病史、相关实验室检查结果,探讨NIHF的病因、发病机制、病理学特征及相关预后等。本研究遵循的程序符合北京市海淀区妇幼保健院人体试验委员会制定的伦理学标准,得到该委员会批准,并与受试对象监护人签署临床研究知情同意书。结果本组41例受试者均为NIHF,22例(53.7%)伴多发畸形,13例(31.7%)伴有单发畸形,6例(14.6%)无明确畸形。NIHF的主要病因以胎儿颈部囊性淋巴管瘤最为多见(26.8%,11/41),其次是胎盘、脐带因素(24.4%,10/41)、心血管畸形(12.2%,5/41)、消化系统畸形(7.3%,3/41)等。临床预后结果显示,选择终止妊娠为24例(58.5%),胎死宫内或晚孕期自然流产为14例(34.1%),胎儿存活为3例(7.3%,2例于新生儿期死亡,1例存活)。结论NIHF的病理学特征及病因分类复杂,胎盘、脐带异常可能是其病因之一,同时胎盘、脐带异常也是NIHF的病理改变之一。NIHF可引起胎盘组织发生相应改变,其预后较差。
Objective To investigate the etiopathogenisis,characteristics of pathology,prognosis and clinical outcomes of nonimmune hydrops fetalis（NIHF）.Methods From January 2003 to December 2012,forty autopsy cases of NIHF and one case of NIHF were included into this study.The clinical history,laboratory examinations were retrospectively analyzed.Furthermore,the etiopathogenisis,pathogenesis,pathology features and prognosis of NIHF were discussed.The study protocol was approved by the Ethical Review Board of Investigation of Haidian Maternal Child Health Hospital.Informed consent was obtained from all participates′patients.Results All of the forty-one cases were diagnosed as NIHF.Among them,twenty-two cases（53.7%）combined multiple malformations,thirteen cases（31.7%）combined single malformations,six cases（14.6%）without explicit malformations.The major etiology and associated diagnosis showed that fetal nuchal cystic hygroma was the most common（53.7%,22/41）,and the following were placenta and umblilical factors（24.4%,10/41）,cardiac abnormalities（12.2%,5/41）and digestion abnormalities（7.3%,3/41）,etc..Furthermore,termination of pregnancy were 24 cases（58.5%）,dead fetus in uterus and abortion during third trimester were 14cases（34.1%）,another 3 cases（7.3%）delivered,but only 1 cases（2.4%）survivaled.Conclusions The pathological features and etiology of NIHF are extremely complex,placenta and umblilical abnormality may be related to the development of NIHF,at the same time,placenta and umblilical abnormality are the pathological changes of NIHF.NIHF could cause relevant changes in placenta with poor prognosis.
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2014年第5期60-63,共4页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
北京市海淀区科技项目(S2013009)~~
关键词
水肿
胎儿
尸体解剖
病理学
临床
胎盘
预后
Hydrops fetalis
Autopsy
Pathology
clinical
Placenta
Prognosis
