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目的探讨并比较当前胎儿脐膨出和腹裂的发生情况及胎儿结局比较。方法对北京市海淀区妇幼保健院2005年1月1日至2008年12月31日期间20例诊断为胎儿脐膨出和腹裂的孕妇的临床资料进行回顾性分析。结果 (1)8例胎儿脐膨出,孕妇平均年龄32.60岁,12例胎儿腹裂,孕妇平均年龄29.4岁;胎儿脐膨出孕妇平均孕次2.2次,胎儿腹裂孕妇平均孕次3次,仅1例胎儿腹裂孕妇有1次自然流产史,其它无不良孕产史记录。在性别方面无差异,脐膨出发生率为1.8/万(8/44094),胎儿腹裂的发生率为2.7/万(12/44094)。(2)4例脐膨出伴发其它结构异常(50%),3例伴有心脏畸形,2例腹裂伴发其它结构异常(16.7%);1例脐膨出胎儿染色体检查异常(12.5%),无腹裂胎儿染色体检查异常。(3)脐膨出首次发现孕周为12～31周,腹裂首次发现孕周为14～37周,脐膨出产前B超诊断率100%,腹裂的诊断率为75%。3例诊断胎儿脐膨出时为死胎(37.5%),其中1例为围产儿死亡(12.5%),18例孕妇选择引产终止妊娠。结论脐膨出常伴有其他先天畸形及染色体异常,围产儿死亡率高。近年来胎儿腹裂的发生率高于脐膨出,由于腹裂胎儿预后好于脐膨出胎儿,应加强脐膨出与腹裂之间的B超鉴别诊断,从而降低围产儿死亡率。
Objective To investigate and compare the current fetal umbilical swelling and the occurrence of ascites and fetal outcome comparison. Methods The clinical data of 20 pregnant women diagnosed as fetal umbilical swelling and ascites from January 1, 2005 to December 31, 2008 in Haidian District Maternal and Child Health Hospital of Beijing were analyzed retrospectively. Results (1) 8 cases of fetal umbilical swelling, the average age of pregnant women 32.60 years old, 12 cases of fetal rupture of the fetus, the average age of pregnant women was 29.4 years; fetus umbilical swelling of pregnant women average pregnancy times 2.2 times, Only 1 case of fetus abdomen pregnant women have a history of spontaneous abortion, and other records without adverse pregnancy history. There was no difference in gender, the incidence of umbilical swelling was 1.8 / million (8/44094), and the incidence of fetal fissure was 2.7 / (12/44094). (2) Four other umbilical swelling associated with other structural abnormalities (50%), three with cardiac malformations, and two other cases of abdominal disruption with other structural abnormalities (16.7%). One case of umbilical swelling fetus had chromosomal abnormalities (12.5 %), Abdominal fetus without chromosomal abnormalities. (3) The umbilical swelling was found for the first time in gestational age from 12 to 31 weeks. The gestational age was 14 to 37 weeks for the first time found in the abdomen. The prenatal B-ultrasonography was 100% in diagnosis of umbilical swelling, and the rate of diagnosis of abdominal distension was 75%. 3 cases of stillbirth (37.5%) were diagnosed during umbilical swelling, of which 1 case was perinatal death (12.5%) and 18 cases were given induction of labor to terminate pregnancy. Conclusion umbilical swelling is often accompanied by other congenital malformations and chromosomal abnormalities, high perinatal mortality. In recent years, the incidence of fetal fissure than umbilical bulging, due to the prognosis of abortion fetus than umbilical bulging fetus, umbilical swelling should be strengthened between the diagnosis of abdominal distension and B ultrasound, thereby reducing perinatal mortality.