临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (9): 658-.doi: 10.3969/j.issn.1000-3606.2017.09.006

• 围产新生儿疾病专栏 • 上一篇    下一篇

非免疫性胎儿水肿 10 例临床分析

蔡成, 龚小慧, 裘刚, 沈云琳, 颜崇兵, 陈一欢, 宋之君   

  1. 上海市儿童医院 上海交通大学附属儿童医院新生儿科(上海 200062)
  • 收稿日期:2017-09-15 出版日期:2017-09-15 发布日期:2017-09-15
  • 通讯作者: 龚小慧  E-mail:gongxh@shchildren.com.cn

Clinical analysis of non-immune hydrops in 10 fetuses

 CAI Cheng, GONG Xiaohui, QIU Gang, SHEN Yunlin, YAN Chongbing, CHEN Yihuan, SONG Zhijun   

  1. Department of Neonatology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
  • Received:2017-09-15 Online:2017-09-15 Published:2017-09-15

摘要:  目的 探讨非免疫性胎儿水肿(NIHF)的临床特点、诊断及治疗。方法 回顾分析2011年1月—2016年12月 新生儿重症监护病房中10例诊断NIHF新生儿的临床资料,并复习相关文献。结果 10例NIHF中,男6例、女4例,出生 胎龄32~42周,出生体质量2.25~3.95 kg。其中感染性疾病3例(巨细胞病毒、无乳链球菌、微小病毒感染各1例),胎儿 心血管异常2例,染色体异常2例,胸腔结构异常1例,双胎输血综合征1例,病因不明1例;临床表现为2处及以上水肿(或 积液) 8例,仅皮肤水肿2例。最终治愈出院6例,自动出院2例,死亡2例。结论 产前超声是诊断NIHF的可靠方法。孕早 期胎儿水肿,尤其伴有先天畸形建议终止妊娠。出生后的NIHF应及时诊治,以避免或减少严重并发症。

Abstract: Objective To explore the clinical features, diagnosis, and treatment of non-immunologic hydrops fetalis (NIHF). Methods The clinical data of 10 cases of NIHF in neonatal intensive case unit during January 2011 to December 2016 were analyzed retrospectively. The related literatures were reviewed. Results In 10 cases of NIHF (6 males and 4 females). the gestational age were 32-42 weeks, and the birth weight was 2.25-3.95 kg. Among them, there were 3 cases of infectious diseases (cytomegalovirus, Streptococcus agalactiae, and parvovirus infection, one case each), 2 cases of fetal cardiovascular abnormalities, 2 cases of chromosomal abnormalities, 1 case of abnormal thoracic structures, 1 case of twin transfusion syndrome, and 1 case of etiology unknown of fetal hydrops. The clinical manifestations showed that there were 8 cases with 2 or more areas of edema (or hydrops), and only 2 cases with skin edema. Finally, 6 cases were cured and discharged, 2 cases were discharged by themself, and 2 cases died. Conclusions Prenatal ultrasound is a reliable method for the diagnosis of NIHF. Fetal edema in early pregnancy, especially with congenital malformations, is recommended for termination of pregnancy. After birth, NIHF should be diagnosed promptly so as to avoid or reduce severe complications.