胎儿脊柱侧凸:自然史和结果

IF 2 Q2 ORTHOPEDICS
Samuel Walters, Ben Barkham, Tim Bishop, Jason Bernard, Christina Coroyannakis, Basky Thilaganathan, Darren F Lui
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引用次数: 0

摘要

介绍:产前超声波检查可发现脊柱侧弯,脊柱侧弯可能与结构和综合征异常有关。与产前诊断脊柱侧弯症相关的关联性和妊娠结局尚不清楚:伦敦一家三级转诊中心进行了一项回顾性队列研究。从产前超声波数据库中确定了1997年至2021年间转诊的脊柱畸形病例。研究结果通过数据库和电子记录得以确认:从转诊的66万名孕妇中发现了123例胎儿脊柱畸形(脊柱侧弯、脊柱后凸或脊柱后凸),发病率约为每1000个胎儿中0.2例。观察到 58 例活产(47.2%)和 65 例(52.8%)胎儿或新生儿死亡或终止妊娠。大多数活产儿为孤立脊柱畸形,产后结果良好(35 例,60.3%)。该组最常见的综合征诊断是 VACTERL 关联(7 例,12.1%)。除 2 例(3.1%)外,大多数胎儿丢失与严重畸形有关,最常见的是脊柱裂、体柄异常、羊膜带序列或染色体异常:结论:这是迄今为止报道的最大规模的产前诊断胎儿脊柱畸形病例系列。结论:这是迄今为止报道的最大规模的产前诊断胎儿脊柱畸形病例系列,证实了胎儿脊柱侧弯及相关脊椎畸形在产前诊断不足,报道的发病率(0.2‰)低于公认的先天性脊柱侧弯发病率(1‰)。同时发现严重畸形与胎儿夭折密切相关。如果是单独发现,大多数胎儿脊柱畸形在出生后都有良好的预后,而每 8 个活产婴儿中就有 1 个被诊断出与 VACTERL 有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fetal Scoliosis: Natural History and Outcomes.

Introduction: Scoliosis can be detected on prenatal ultrasonography and may be associated with structural and syndromic abnormalities. Associations and pregnancy outcomes related to the prenatal diagnosis of scoliosis are poorly understood.

Methods: A retrospective cohort study was undertaken at a tertiary referral center in London. Referred cases with spinal deformities between 1997 and 2021 were identified from the prenatal ultrasonography database. Outcomes were ascertained from the database and electronic notes.

Results: One hundred twenty-three cases of fetal spinal deformities (scoliosis, kyphosis, or kyphoscoliosis) were identified from a referral population of 660,000 pregnancies, giving an incidence of approximately 0.2 per 1000 fetuses. Fifty-eight live births (47.2%) and 65 cases (52.8%) of fetal or neonatal demise or termination were observed. Most live births were isolated spinal deformities with a good postnatal outcome (n = 35, 60.3%). The commonest syndromic diagnosis in this group was VACTERL association (n = 7, 12.1%). Most cases of fetal loss were associated with severe malformations, most commonly spina bifida, body stalk anomaly and amniotic band sequence, or chromosomal abnormalities, except in 2 cases (3.1%).

Conclusions: This is the largest reported cases series to date of prenatally diagnosed fetal spinal deformity. This confirms that fetal scoliosis and associated vertebral abnormalities are underdiagnosed prenatally, with the reported incidence (0.2 per 1000) lower than the recognized incidence of congenital scoliosis (1 in 1,000). The concurrent finding of severe malformations was strongly associated with fetal loss. When an isolated finding, most fetal spinal deformities had a good postnatal outcome, while 1:8 live births were diagnosed with VACTERL association.

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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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