胎儿膈疝能再宫内治疗吗?
严重膈疝由于肺部发育不良死亡率高,如不伴有染色体异常,可在宫内将气管封堵,使肺部液体发生积聚,促使肺部膨胀,避免腹腔脏器进一步疝入胸腔,减轻膈疝引致的肺部发育不良
胎儿膈疝宫内治疗: 26-30周行胎儿镜下气管封堵术,在超声引导下,将trocar经孕妇腹壁穿刺进入羊膜腔,胎儿镜经胎儿口腔进入气管,在气管隆突处推出球囊并充气、释放。可于34周胎儿镜下取出球囊或在分娩时行子宫外产时外科手术(EXIT)将球囊取出。
胎儿镜下气管封堵术



参考文献:
- Graves CE, et al. Minimally Invasive Fetal Surgery. Clin Perinatol. 2017
- Chescheir NC. Maternal–Fetal Surgery Where Are We and How Did We Get Here? Obstet Gynecol. 2009