Hình ảnh siêu âm và một số yếu tố tiên lượng trong dị dạng bạch mạch dạng nang

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Xuân Sang Nguyễn, Danh Cường Trần

Ngôn ngữ: Vie

Ký hiệu phân loại: 618 Other branches of medicine Gynecology and obstetrics

Thông tin xuất bản: Y học cộng đồng 2023

Mô tả vật lý: 252-258

Bộ sưu tập: Metadata

ID: 401648

Thêm vào giỏ Liên kết toàn văn

Tóm tắt
Chủ đề

Mô tả hình ảnh siêu âm và kết quả di truyền mẫu dịch ối nhằm tiên lượng kết cục thai kỳ những trường hợp dị dạng bạch mạch dạng nang. Đối tượng và phương pháp nghiên cứu:Thiết kế mô tả theo dõi dọc 200 thai phụ được siêu âm hội chẩn trước sinh với chẩn đoán thai dị dạng bạch mạch dạng nang tại Trung tâm CĐTS - Bệnh viện phụ sản Trung Ương từ tháng 01/202 - 07/2022. Kết quả: Dị dạng bạch mạch dạng nang (Hygroma Kystique- HK) được chẩn đoán phần lớn tại thời điểm quý I và đầu quý II thai kỳ: Tuổi thai trung bình là 12,8 ± 1,5 tuần (11 tuần - 22,5 tuần) trong đó 82% ở quý I, 18% ở quý II. Độ dày da gáy trung bình là 8,4 ± 3,3mm (3mm-26,8mm). Tỷ lệ bất thường kèm theo trong HK là 69% với tình trạng phù thai và phù toàn thân chiếm 64%. Bất thường NST là 31,8% gồm bất thường số lượng NST hay gặp là 45 XO (HC Tuner) và bất thường cấu trúc NST như microdeletion 10p14 (HC DiGeorge), microdeletion 4p16.3 (HC Wolf- Hirschhorn). Bất thường hình thái trong các trường hợp có NST bình thường là 26,7%, chủ yếu là bất thường tim chiếm 50%. Tiên lượng thai kỳ tốt trong các trường hợp có siêu âm hình thái và kết quả NST bình thường. Tỷ lệ trẻ sống sau sinh là 5% với nhóm đơn độc là 16,13%.Kết luận: Hình ảnh siêu âm điển hình là da gáy dày, có vách ngăn kèm theo phù thai hoặc phù toàn thân. Độ dày da gáy có mối liên quan đến bất thường số lượng hoặc kèm theo cấu trúc NST. Tiên lượng thai kỳ tốt ở những trường hợp có độ dày da gáy <
6 mm, không có bất thường kèm theo và NST bình thường. Dị dạng bạch mạch dạng nang có thể được chẩn đoán sớm trong quý I thai kỳ., Tóm tắt tiếng anh, To describe ultrasound characteristics and results of the amniocentesis analysis to predict pregnancy outcomes in cases of Hygroma Kystique. Materials and methods: A cohort study of 200 fetuses have prenatal consultation with the diagnosis of Hygroma Kystique at the Prenatal Diagnosis Center of the National Hospital of Obstetrics and Gynecology from 01/2021 to 07/2022. Results: 82% of cases were diagnosed in the first trimester, and 18% in the early second trimester: Median gestation at diagnosis is12,8 ± 1,5 weeks ( 11 - 22.5mm). The average nuchal thickness was 8,4 ± 3,3 mm (3 mm- 26,8mm). The increase of the nuchal thickness leads to the risk of abnormalities, especially with hydrops fetalis (nuchal thickness ≥ 10mm, the rate of hydrops fetalis was 78%
chromosomal abnormalities was 50%).The results of abnormal chromosomes were 31,8%, The most common aneuploidy was Tuner syndrome, Down syndrome, or structural abnormalities such as DiGeorge syndrome.Morphological abnormalities in chromosomal normal cases were 23.7%, of which mainly cardiac abnormalities (50%).Survival was 5% in the study group. Postpartum survivors had normal chromosomal findings and no associated morphological abnormalities.Conclusion: Hygroma Kystiquecan be diagnosed early in the first trimester of pregnancy, often accompanied by a variety of morphological abnormalities, mainly hydrops fetalis. Nuchal thickness is related to abnormal number and chromosomal abnormalities. In addition to the abnormal number of chromosomes, there may also be an abnormality in the structure of the chromosomes. The prognosis of pregnancy is good in cases where there are no associated abnormalities and normal chromosomes.

1.

Tạo bộ sưu tập với mã QR