临时器官病理学,妊娠和分娩并发症,新生儿先天性泌尿和神经系统缺陷的状况

I. Luk’yanova, I. Gordienko, G. Medvedenko, G. Grebinichenko, B. Tarasyuk
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引用次数: 0

摘要

胎儿和新生儿先天性畸形是围产期发病和死亡的主要原因。在这类人群中,供体器官畸形和功能障碍的研究较少。目的:分析胎儿和新生儿中枢神经系统(CNS)和/或肾-泌尿系统(NUS) CM存在时的妊娠过程、临时脏器超声显像资料。材料和方法。分析2017-2021年产前诊断为CNS CM和/或NUS病例的产前和产后超声结果、记忆和一般临床资料。结果。新生儿CNS畸形45例,新生儿CM 54例。新生儿NUS和/或中枢神经系统畸形合并其他系统异常的病例占三分之一,分别为29.6%和31.1%。产前超声检查结果显示,NUS型CM多见于羊水过多(16.7%),CNS型CM多见于胎盘增生(35.6%)、胎儿生长迟缓(24.4%)和胎儿窘迫(26.7%)。两组新生儿(NUS畸形和CNS畸形)出生后的并发症发生率均较高:早产(分别为16.7%和15.6%)、出生窒息(分别为48%和55.6%)和新生儿早期死亡(分别为11%和6.6%)。Сonclusions。伴有中枢神经系统CM和(或)胎儿NUS的孕妇因其围产期并发症发生率高,属于围产期高危人群。对于患有中枢神经系统CM和/或NUS的胎儿和新生儿,应向父母提供有关围产期高风险的信息,并在计划妊娠和分娩管理时予以考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pathology of provisional organs, complications of pregnancy and labor, and the condition of newborn with congenital defects of the urinary and nervous systems
Congenital malformations (CM) in fetuses and neonates belong to main causes of perinatal morbidity and mortality. Provision organs malformation and malfunction in such cohorts is less studied. The purpose - to analyze the course of pregnancy, the data of ultrasound imaging of provisional organs in the presence of CM of central nervous system (CNS) and/or of nephro-urinary system (NUS) in the fetus and newborn. Materials and methods. The results of prenatal and postnatal ultrasound, anamnestic and general clinical data of a sample of cases with prenatally diagnosed CM of CNS and/or NUS for the period 2017-2021 were analyzed. Results. There were 45 newborns with CNS malformations, and 54 newborns with CM of NUS. Malformations of NUS and/or CNS in the examined newborns were combined with anomalies of other systems in a third of cases - 29.6% and 31.1%, respectively. According to the results of prenatal ultrasound examinations, polyhydramnios (16.7%) was most often recorded in the pregnancies with fetal CM of NUS, and cases of fetal CM of CNS most commonly were registered placental hyperplasia (35.6%), fetal growth retardation (24.4%) and fetal distress (26.7%). Postnatally in both cohorts (with NUS malformations and with CNS malformations) a high rate of following complications were recorded: prematurity (16.7% and 15.6%, respectively), birth asphyxia (48% and 55.6%, respectively), and early neonatal death (11% and 6.6%). Сonclusions. Pregnant women with CM of CNS and/or NUS in the fetus belong to the group of high perinatal risk because of the high rate of perinatal complications. Information about the identified high perinatal risks in fetuses and newborns with CM of the CNS and/or NUS should be provided to parents and taken into account when planning management of pregnancy and labor.
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