How to diagnose fetal water sac tumor?
summary
The incidence of fetal tumor accounts for about 1.7-13.5/100000 of all live births, and this situation may generally lead to physical problems of patients. Of course, with stillbirth, miscarriage of fetuses and unreported grey data, there are actually more than that. The rapid development of prenatal diagnosis of fetal tumor has won time for neonatal surgeons and obstetricians to choose proper treatment methods, provided more initiative for the prevention and treatment of fetal tumor, and avoided many tragedies that should not have happened. Now let me talk to you about how to diagnose fetal water sac tumor?.
How to diagnose fetal water sac tumor?
First, ultrasound examination of fetal tumors can show special ultrasound images, including calcification, liquefaction, organ edema, internal bleeding and neovascularization, etc. Brain tumor should be considered when fetal brain tissue is occupied by mass, cystic or shadow, brain midline deviation or complicated with hydrocephalus or ventricular dilatation. Neck mass can be shown as local mass shadow and surrounding tissue deformation and displacement caused by compression. For example, neck lymphoma or hemangioma can compress trachea and esophagus, often accompanied by excessive amniotic fluid, but it is difficult to judge the source. Subcutaneous soft tissue effusion in the neck and back can be observed at 9 weeks of gestation, and it is easy to diagnose in cervical lymphangioma. The commonly used ultrasonic evidences for fetal heart abnormalities include: lack of normal anatomical structure, disordered appearance in normal anatomical structure, abnormal structure in texture or size, blood flow obstruction, atrioventricular stenosis, abnormal fetal movement, or abnormal fetal heart rhythm, pleural effusion, pericardial tamponade, and polyhydramnios in endocardial tumors, Fetal edema. Hepatomegaly with splenomegaly, intrahepatic space occupying, calcification, arteriovenous shunt, fetal edema, pleural effusion, ascites, oligohydramnios or polyhydramnios may occur in liver tumors. Hemangioma of the liver can be accompanied by skin hemangioma, placental edema, chorionic hemangioma and omphalocele syndrome.
Second: MRI examination is non radioactive, high resolution, good contrast, large amount of information, for fetal solid tumor location, especially intracranial tumor can detect lesions more early. Studies have shown that when the fetus is complicated with sacrococcygeal teratoma, measuring the waveform and velocity of umbilical artery blood flow is helpful to predict the prognosis of the fetus. If the monitoring shows that the peak value of umbilical blood flow decreases and the resistance of placental blood circulation increases, pregnancy should be terminated as soon as possible.
Third, the increase of maternal serum alpha fetoprotein (AFP) level by biochemical examination can help to diagnose fetal sacrococcygeal teratoma. After tumor resection, maternal serum AFP level decreases rapidly. However, it is still controversial whether immature teratoma with yolk sac component can lead to the increase of maternal serum AFP. In addition, the increase of maternal serum AFP can also be seen in fetal hepatoblastoma, intracranial tumor and fetal hemangioma. For fetal adnexal tumors with trophoblastic components, maternal serum β- Human chorionic gonadotropin（ β- The hCG level was abnormally increased, while the PLF level was significantly lower than that of normal pregnancy.
matters needing attention
To sum up, most of the fetal tumor ultrasound performance has certain characteristics, prenatal ultrasound diagnosis is not difficult, but in the first and second trimester of pregnancy may not be found, so pay attention to the whole pregnancy prenatal ultrasound examination, maintain dynamic follow-up monitoring has important clinical value. Prenatal ultrasound has limitations in the localization of some tumors, such as retroperitoneal and intracranial tumors. MRI and CT should be combined when necessary. Prenatal ultrasound can predict the clinical prognosis of fetuses with tumor lesions, and can provide reference for family members.
