昨天发了巨膀胱后,读者纷纷留言:超过多少数值才能够诊断巨膀胱??那么,巨膀胱究竟有多巨?永远究竟有多远?这个胎儿12周,膀胱纵径13mm,我们诊断巨膀胱。标准如下:
1,在孕10到14周,膀胱纵径≥7mm,可以诊断巨膀胱
2,膀胱纵径>15mm,是严重的巨膀胱,常常会发展成尿路梗阻
3,如果膀胱纵径在7-15mm,90%胎儿的巨膀胱到孕20周时会自己消失
4,孕11-15周,巨膀胱发病率为0.3%
5,有学者统计了例早孕期发现的巨膀胱胎儿,结果其中21%有染色体异常。
随访!动态观察极其重要!
严重巨膀胱预后很差,即使通过手术,即使勉强活到新生儿期,仍然有肾衰的危险性!
Fetalmegacystishasbeenreportedasearlyas10to14weeks’gestationwhenthelongitudinalbladderdiameteris7mmormore,Theincidenceis0.3%at11to15weeks.Inthelargestcaseseriesoffetuseswithearlymegacystis,chromosomalabnormalitiesweredetectedin21%.Inthechromo-somallynormalgroup,severemegacystis(bladderlength15mm)wasinvariablyassociatedwithprogressiveobstructiveuropathy.However,ifthebladderlengthwas7to15mm,therewasspontaneousresolutionofthemegacystisby20weeksin90%ofcases.Therefore,follow-upultrasoundisnecessarytointerpretcorrectlytheimportanceofmegacystisdetectedinthe1sttrimester.Theroleofearlyvesicocentesisandshuntplacementneedsfurtherinvestigation.Infetuseswithseveremegacystis,survivaltotheneonatalperiodwaspoorevenwithintervention,andthesurvivorsareatriskofdevelopingrenalfailure.
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