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Prenatal diagnosis and clinical prognosis of fetal hyperechogenic kidneys
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OBSTETRICS AND GYNECOLOGY
- Issue:
- 4
- DOI:
- 10.3760/j.issn:0529-567x.2007.04.006
- Key Word:
- 超声检查,产前;多囊肾疾病;肾疾病;肾
Abstract： 目的 探讨B超检查胎儿肾脏回声增强的临床意义.方法 选择31例产前B超发现胎儿肾脏回声增强的患者,征求本人意见,对选择引产放弃胎儿者(12例)行引产后患儿尸体解剖;对选择继续妊娠者(19例)定期随访.分娩时取胎儿脐带血进行胎儿染色体分析.结果 (1)31例中6例胎儿同时合并其他脏器异常,3例胎儿合并染色体异常,2例患者具有家族史.(2)12例选择终止妊娠者中,10例伴羊水过少;B超检查胎儿肾脏回声增强的原因分别为婴儿型多囊肾10例、成人型多囊肾1例和多囊性肾发育不良1例.(3)19例选择继续妊娠者中,2例羊水过少患儿于新生儿期死亡,病理解剖结果为婴儿型多囊肾;3例患儿分别在出生后1岁内死亡,病理诊断分别为婴儿型多囊肾或多囊性肾发育不良;1例患儿在出生后26个月出现高血压症状,肾功能异常,诊断为婴儿型多囊肾;4例患儿出生后B超检查肾脏回声转为正常;9例肾脏B超表现与产前检查相同,但目前没有任何临床症状.结论 (1)胎儿期肾脏B超回声增强的原因多为婴儿型多囊肾、肾发育不良和非特异性肾病,也有部分为正常肾脏变异.(2)羊水量是判断胎儿预后的关键指标之一,当胎儿期肾脏回声增强伴羊水过少时提示胎儿预后不良.(3)当发现肾脏B超回声增强时,应仔细询问家族史,并对胎儿父母肾脏及胎儿其他部位进行详细检查,必要时建议进行胎儿染色体核型分析.
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