产前诊断中胎儿超声软指标阳性的临床处理与预后分析  

Prenatal diagnostics and outcome of ultrasonographic soft markers

作　　者：顾蔚蓉[1] 李笑天[1] 严英榴[1] 张月萍[1] 朱铭伟[1] 张珏华[1] 周毓青[1] 

机构地区：[1]复旦大学附属妇产科医院产前诊断中心,上海200011

出　　处：《复旦学报（医学版）》2010年第2期180-183,188,共5页Fudan University Journal of Medical Sciences

摘　　要：目的探讨产前诊断中对于胎儿超声软指标阳性的临床处理及其预后。方法研究对象为2005年1月1日至2009年3月31日期间在本院多科会诊的268例胎儿超声软指标阳性的孕妇,分析胎儿的转归及染色体检查情况。结果268例孕妇中继续妊娠至分娩者205例(76.5%),引产34例(12.7%),失访29例(10.8%)。孤立软指标中,继续妊娠至分娩者中颈项软组织增厚、轻度肾盂扩张、肠管强回声及长骨短小者占前4位。轻度脑室扩张引产率最高(达17.2%)。胎儿染色体检查率22.0%,染色体异常率2.6%,1例为21三体,其余为染色体结构异常。结论超声软指标阳性者除提示胎儿三体型风险外,染色体结构异常风险亦增加。孤立软指标阳性预后不良者少,产前诊断中需加强咨询指导,减少不必要的侵入性检查及引产。Objective To review the clinical treatment and outcome of ultrasonographic soft markers in prenatal diagnostics. Methods This study recruited 268 pregnant women who underwent prenatal diagnostics in our hospital between Jun 2005 to Mar 2009. Fetuses were followed up postnatally. The outcome and chromosomal abnormalities of ultrasonographic soft markers were assessed. Results Of 268 cases consulted, 29 cases were missed （10.8%）, 34 cases （12.7%） chose abortion, and 205 cases （76.5%） delivered. The top four most common delivered isolated markers were thickened nuchal fold, mild pyelectasis, echogenic bowel and rhizomelic limb shortening. Mild ventriculomegals had the highest aborted rate （17.2%）. Six chromosomal structural abnormalities and one 21-trisome were detected in 59 fetuses who received chromosomal examination. Conclusions Ultrasonographic soft markers are risks to both fetal trisome and chromosomal structural abnormalities. Owing to extinction in most cases, consultant should be strengthed to avoid unnecessary invasive examination and abortion.

关 键 词：染色体异常 胎儿 产前诊断 超声软指标 

分 类 号：R714.53[医药卫生—妇产科学]