妊娠早期腹裂的超声检测:妊娠管理和结局的现状

Q4 Medicine Revista Romana de Pediatrie Pub Date : 2021-12-31 DOI:10.37897/rjp.2021.4.5
Dragoş Tudorache, R. Bohîlțea, Paul Costin Pariza, Vlad Dima, C. Grigoriu, B. Mihai, C. Berceanu, R. Vlădăreanu
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引用次数: 0

摘要

腹裂是一种先天性腹前壁缺陷,每10000名新生儿中就有4至5人发生,包括在没有膜覆盖物的情况下,在羊膜腔中取出肠管。腹裂病例可以在妊娠早期使用超声检查或在妊娠中期开始时检测到,检测率为100%。尽管在大多数情况下是一种孤立的情况,但可能会出现进一步的并发症,如旋转不良、闭锁、狭窄、穿孔或扭转。需要定期监测,在每次超声检查时测量羊水水平、胎儿生物测量和肠道直径,以评估妊娠进展。腹裂最常与羊水过少、胎儿宫内生长受限、肠壁厚度增加和肠扩张有关。该疾病的结果是有利的,出生婴儿的存活率约为90%。长期使用呼吸机和多次肠道手术延迟了口服喂养的时间,同时长期使用父母的全营养和短肠综合征是最重要的合并症。建议在妊娠38周分娩,复杂腹裂保留剖腹产。尽管腹裂是一种复杂的病理学,但它与正常的智力发育有关,很少甚至没有长期并发症。
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Ultrasonographic detection of gastroschisis in the first trimester: Actualities in pregnancy management and outcome
Gastroschisis is a congenital anterior abdominal wall defect that occurs in 4 to 5 in 10,000 births, consisting in the evisceration of bowel in the amniotic cavity without a membranous covering. Gastroschisis cases can be detected during the first trimester using ultrasonography or at the beginning of the second trimester with a detection rate of 100%. Although an isolated condition in most of the cases, further complications such as malrotation, atresia, stenosis, perforation or volvulus can be associated. Periodic monitoring is required to assess the progress of the pregnancy with measurements of the level of amniotic fluid, fetal biometry and bowel diameters at every ultrasound examination. Gastroschisis is most frequently associated with oligohydramnios, intrauterine fetal growth restriction, increased bowel wall thickness and bowel dilatation. The outcome of the disease is favorable with a survival rate of around 90% for born infants. The long time on ventilator and multiple intestinal surgeries that delay the moment of oral feeding with a long-term use of total parental nutrition and short bowel syndrome are the most important comorbidities. Delivery is recommended at 38 weeks of gestation, preserving caesarean delivery for complicated gastroschisis. Although a complex pathology, gastroschisis is associated with normal intellectual development and few to none long-term complications.
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来源期刊
CiteScore
0.10
自引率
0.00%
发文量
15
审稿时长
4 weeks
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