양수감소증을 동반한 태아의 부검소견
Autopsy Findings in Fetuses with Oligohydramnios
이상동, 윤종병,
소속 상세정보
이상동 ( )
부산대학교병원 비뇨기과학교실
윤종병 ( )
세강병원 비뇨기과
KMID : 0358319980390010077
Abstract
결론
1986부터 1991년까지 부검을 실시한 태아 301례중 양수감소증을 동반한 18례를 후향적으
로 조사하여 다음과 같은 결론을 얻었다.
1. 태생기 2기 이후 의미있는 양수감소증을 동반한 태아는 타장기 기형을 동반하는 경향이
있었다.
2. 양수감소증을 동반한 태아의 가장 흔한 사망원인은 폐저형성증이며 양수감소증의 가장
흔한 원인은 비뇨기계 기형이었다.
3. 태생기 2기 이후 의미있는 양수감소증을 동반한 태아는 비뇨기계 기형의 동반유무에 관
계없이 매우 예후가 나빴다.
#초록#
Purpose: After 16 weeks of gestational age, amniotic fluid is mainly consisted fetal
urine. There is a close correlation between oligohydramnios associated with urinary tract
anomaly and pulmonary development. Therefore, fetuses with oligohydramnios starting in
the second trimester are considered to have uniformly fatal outcomes. We try to survey
clinical characteristics of fetuses with oligohydramnios on autopsy and to find the need
of perinatal management in fetuses with urinary tract anomaly and oligohydramnios
which is occurred since second trimester.
Materials and Methods: We retrospectively analysed gestational age at presentation,
maternal age, causes of oligohydramnios, external physical examination, prenatal
sonographic findings, underlying urologic anomalies, associated anomalies of other organs
and ultimate outcomes in eighteen fetuses with oligohydramnios among 301 autopsy
fetuses from 1986 to 1991.
Results: It occurred predominantly in male as a ratio of 2.6:1 Gestational age of fetuses
at presentation ranged from 21 to 47 weeks(average: 32.6) and maternal age from 20 to
33 years(average: 28.3). Causes of oligohydramnios in 18 fetuses ware fetal renal
anomalies with intrauterine growth retardation(IUGR)(6), fetal renal anomalies(3), fetal
death in uterine(3), urinary tract obstruction with IUGR(2) et al Inaccuracy rate between
prenatal sonographic findings and autopsy findings was 53.8%, 0% in fetuses with
urologic anomalies and with non-urologic anomalies, respectively. Underlying urinary
tract anomalies consisted of bilateral renal dysplasia(4), posterior urethral valves(2),
bilateral renal agenesis(1), bilateral renal hypoplasia(1), unilateral renal dysplasia and
contralateral renal hypoplasia(1), infantile polycyctic kidney(1) et al. The most frequent
anomaly of other organ was respiratory system anomalies, especially pulmonary
hypoplasia. The prognosis in our cases with oligohydramnios was dismal as much as all
fetuses except one, still birth, died of respiratory failure at perinatal periods.
Conclusions: Based on these experiences we have the policy to induce delivery and
early perinatal management in cases with second or third trimester onset of severe
oligohydramnics with urinary tract abnormalites.
키워드
Fetus; Autopsy finding; Oligohydramnios;
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