胎儿颅内出血的研究进展

doi:10.12280/gjfckx.20230234

摘要/Abstract

摘要：

胎儿颅内出血（fetal intracranial hemorrhage，FICH）是临床上一种罕见的脑损伤事件，多发生于妊娠中晚期。因胎儿颅脑结构的特殊性，其发病机制可能与生发层的发育、凝血功能及胎儿颅内血管自身调节功能有关。FICH多为常规孕检时偶然发现，临床表现不典型，部分患者病情进展急骤。FICH诊断无金标准，影像学表现复杂多变，主要依靠产前超声和磁共振成像检查协助诊断，其需与胎儿颅内肿瘤、Galen静脉瘤、蛛网膜囊肿和颅内钙化等疾病相鉴别。根据出血部位、出血范围不同，FICH可导致不同程度的神经功能障碍，甚至死亡，预后存在较大差异。综述FICH的研究进展，旨在加深临床医生对该病的认识，切实提高临床诊治能力，在减少盲目引产的同时降低严重神经系统后遗症患儿的出生率。

关键词: 胎儿, 颅内出血, 危险因素, 磁共振成像, 超声检查, 产前, 产前诊断, 侧脑室

Abstract:

Fetal intracranial hemorrhage (FICH) is a rare clinical event of brain injury, mostly occurring in the middle and late stages of pregnancy. Because of the particularity of fetal brain structure, its pathogenesis may be related to the development of germinal layer, coagulation function and the autoregulation function of fetal intracranial vessels. FICH is often discovered by chance during routine pregnancy examinations, with atypical clinical manifestations and some patients progressing rapidly. There is no gold standard for FICH diagnosis, and the imaging manifestations are complex and varied. The diagnosis mainly relies on prenatal ultrasound and magnetic resonance imaging to assist, which needs to be distinguished from fetal intracranial tumors, Galen′s venous tumors, arachnoid cysts, and intracranial calcification. Depending on the location and extent of the hemorrhage, it can lead to varying degrees of neurological dysfunction and even death, with significant differences in prognosis. Summarize the research progress of FICH, aiming to deepen the understanding of the disease among clinical doctors, effectively improve clinical diagnosis and treatment capabilities, and reduce the birth rate of children with severe neurological sequelae while reducing the number of blindly induced abortions.

Key words: Fetus, Intracranial hemorrhages, Risk factors, Magnetic resonance imaging, Ultrasonography, prenatal, Prenatal diagnosis, Lateral ventricles

马帅, 徐影, 王敏, 李杰. 胎儿颅内出血的研究进展[J]. 国际妇产科学杂志, 2023, 50(5): 481-485.

MA Shuai, XU Ying, WANG Min, LI Jie. Advances in the Study of Fetal Intracranial Hemorrhage[J]. Journal of International Obstetrics and Gynecology, 2023, 50(5): 481-485.

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