METHODS: 173 patients were included. Standardized ultrasound examinations including MCA and umbilical artery (UA) Doppler as well as assessment of HH presence and regression were performed. Fetuses with MCA-RI <5th percentile (P) before fetal surgery were compared to the group with normal MCA-RI and correlated to the presence of HH before and its regression after fSB repair.
RESULTS: 30% (49/161) fetuses showed RI\'s <5th P before fSB repair. All fetuses had normal UA-RI. 99.4% of fetuses (160/161) showed normal of MCA-RI before delivery. Normalization occurred within a mean of 1.3 ± 1.2 weeks. HH regression was observed in 97% in the group with normal MCA-RI and in 96% in the group with MCA-RI <5th P before surgery (p = 0.59). Time lapse to HH regression after fSB repair was 1.8 ± 1.7 and 1.9 ± 1.6 weeks, respectively.
CONCLUSIONS: In fetuses with MCA-RIs <5 P before fSB repair, a parallel timely course of MCA-RI normalization and HH regression was noted. To suggest common pathogenic factor(s), more studies are needed. However, normalization of the fetal cerebral circulation could be a further benefit of fSB repair.
方法:纳入173例患者。进行了标准化的超声检查,包括MCA和脐动脉(UA)多普勒,以及对HH的存在和消退的评估。患有MCA-RI的胎儿第5百分位数(P.)将胎儿手术前与MCA-RI正常的组进行比较,并与FSB修复前HH的存在及其消退相关。
结果:30%(49/161)的胎儿在fSB修复前显示RI/s<5thP。所有胎儿的UA-RI正常。99.4%(160/161)的胎儿在分娩前显示MCA-RI正常。标准化发生在平均1.3±1.2周内。在MCA-RI正常的组中观察到97%的HH消退,在MCA-RI&lt;5thP的组中观察到96%的HH消退。术前(p=0.59)。fSB修复后HH消退的时间分别为1.8±1.7和1.9±1.6周。
结论:在患有MCA-RI的胎儿中<5.P在fSB修理之前,观察到MCA-RI正常化和HH回归的平行及时过程.提示常见致病因素,需要更多的研究。然而,胎儿脑循环的正常化可能是fSB修复的进一步益处。