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頁籤選單縮合
| 題 名 | Risk of Fetal Chromosomal Abnormalities in Idiopathic Polyhydramnios=不明原因性羊水量過多症與異常胎兒染色體的關係 |
|---|---|
| 作 者 | 李晉峰; 王國恭; 藍中基; | 書刊名 | 中華醫學雜誌 |
| 卷 期 | 57:1 1996.01[民85.01] |
| 頁 次 | 頁42-46 |
| 分類號 | 417.133 |
| 關鍵詞 | 胎兒染色體檢查; 不明原因性羊水過多; 超音波檢查; Fetal karyotyping; Idiopathic polyhydramnios; Sonographic examination; |
| 語 文 | 英文(English) |
| 中文摘要 | 背景:羊水量過多的懷孕,經常會合併有胎兒的先天性畸形。當產前超音波檢查發現羊水量過多合併有胎兒畸形的存在時,孕婦通常會被建議接受胎兒染色體的評估,但是當孕婦是屬於不明原因性的羊水量過多,胎兒染色體檢查的重要性往往就被忽略了。本研究中,我們評估了在不明原因性羊水量過多時,胎兒是否應該接受染色體檢查。 方法:33位具有不明原因性羊水量過多的孕婦,接受了產前胎兒染色體檢查。之後,對於染色體檢查結果不正常的胎兒,我們再次給予詳細的第二級超音波檢查,以確定羊水量過多確實屬於不明原因性。產下的染色體異常嬰兒中有四位接受了解剖或其他檢查,以便與產前超音波檢查的結果作為比較。 結果:我們驚訝地發現,在33位不明原因性羊水量過多的孕婦中,有7位(22.2%)具有不正常的胎兒染色體。這7位病例再次接受詳細的第二級超音波檢查,結果其中3位其實可發現有胎兒的先天性畸形。因此,對於任何年齡的懷孕合併真正的不明原因性羊水量過多,胎兒染色體異常的發生率為13.3%(4/30)。若進一步再將超過34歲的高齡產婦也去除於本研究中,那麼,小於34歲的孕婦合併真正的不明原因性羊水量過多時,胎兒發生染色體異常的機率為8.3%(2/24)。 結論:無論是依據本研究的發現,或是他人的研究結果,不明原因性羊水量過多的懷孕發生胎兒染色體異常的機率,都遠比34歲孕婦生下染色體異常胎兒的機率來的高。既然產科醫師會建議34歲以上的高齡產婦接受胎兒的染色體檢查,我們更是應該建議懷孕合併不明原因性的羊水量過多時,胎兒應該接受產前染色體的評估。 |
| 英文摘要 | Background: Polyhydramnios is often associated with fetal anatomical abnormalities; thus chromosome analysis is indicated for fetuses with those indications. However, chromosome analysis for patients with idiopathic polyhydramnios is often overlooked. This is an attempt to evaluate the necessity for chromosome analysis in pregnancies with idiopathic polyhydramnios. Methods: Genetic amniocentesis or percutaneous umbilical blood sampling was done in 33 cases with idiopathic polyhydramnios which appeared at 26 to 34 weeks' gestation. To exclude false idiopathic polyhydramniotic cases, a level II sonographic examination was carefully performed for those fetuses with abnormal chromosome. Autopsy ultrasound examination and X-ray examination were done in four neonates with abnormal karyotypes, and the results were compared with prenatal sonographic findings. Results: Seven (21.2%) out of the 33 cases were, surprisingly found to have chromosomal abnormalities. Three out of the seven cases were diagnosed to have fetal anatomical defects, at a repeated level II sonographic examination. The incidence of fetal chromosome abnormalities in idiopathic polyhydramnios was 13.3% (4/30). After 7 cases of women older than 34 years and 3 cases with false idiopathic polyhydramnios were excluded, the incidence of chromosomal abnormalities in pregnancies of those under 34 years of age with idiopathic polyhydramnios was 8.3% (2/24). Conclusions: According to the results of this study and other papers, the incidence of chromosomal abnormalities in fetuses with idiopathic polyhydramnios is much higher than that for maternal age specific risk at 34 years of age. Therefore fetal chromosome analysis for pregnancies with idiopathic polyhydramnios is recommended to avoid unnecessary Cesarean sections and deliveries of viable babies with abnormal chromosomes. |
本系統中英文摘要資訊取自各篇刊載內容。