基层医院超声诊断单脐动脉与胎儿畸形相关性研究  

Relationship between Fetal Malformation and Single Umbilical Artery Diagnosed before Pregnancy in the Primary Hospital

作　　者：蔡少雨[1] 李玉球[1] 贺青蓉[2] 黎雪玲[2] 

机构地区：[1]广东省佛山市高明区人民医院超声诊断中心,528500 [2]广东省佛山市高明区人民医院妇产科,528500

出　　处：《中华全科医学》2010年第8期1047-1049,共3页Chinese Journal of General Practice

摘　　要：目的探讨超声检测胎儿脐带血管数目与胎儿畸形之间的相关性。方法进行常规产前超声检查中发现胎儿单脐动脉共20例,分析单脐动脉合并畸形的类型,以及与染色体异常的关系和胎儿结局。结果胎儿单脐动脉20例中,单纯性单脐动脉12例(60%),合并其他结构畸形5例(25%),其中1例为胎儿先天性心脏畸形:完全型房室共道畸形,胎儿小脑蚓部缺如,胎儿右侧腹部囊肿,羊水过多,胎儿生长受限(FGR)(5%);1例为胎儿双侧脉络膜囊肿(5%);1例为内脏外翻合并心脏外露(5%);1例为先天性膈疝,一侧肾重度积水(5%);1例为胎儿巨大脐膨出并腹腔内肝脏膨出及大量腹水,胎儿心脏异常,FGR(5%);单纯性FGR3例(15%)。结论基层医院产前超声诊断单脐动脉并进一步检查胎儿有无多器官发育畸形,为基层医院产前咨询及临床处理提供重要的依据。对于基层医院发现单纯性单脐动脉胎儿,在低风险人群中染色体检查并不是必要的,而对于合并有其他结构畸形的单脐动脉胎儿,有必要建议上级医院行胎儿染色体检查。Objective To evaluate the value of single umbilical arteryt（SUA）in predicting fetal congenital malformations.Methods From December 2005 to July 2009,SUA was diagnosed in 20 fetuses in our hospital.Color flow imaging of the fetal pelvis was used to determine the number and side of umbilical arteries.The associated anomalies,karyotype,Doppler findings and perinatal outcome of the fetuses with SUA were analyzed,and the literatures were reviewed.Results SUA was diagnosed in 20 cases.SUA as an isolated finding occurred in 12（60%）fetuses,and 5（25%）cases had associated malformations,including one（5%）case of fetal congenital heart disease：complete atrioventricular total tract abnormalities,absence of fetal cerebellar vermis,the right of fetal abdominal cyst,polyhydramnios,fetal growth restriction（FGR）;one（5%）case of congenital bilateral choroid cysts;one（5%）case of visceral valgus and the heart exposed;one（5%）case of congenital diaphragmatic hernia,one side severe hydronephrosis;one（5%）case of large omphalocele and the liver exposed,and massive ascites,heart abnormalities,FRG;3（15%）cases of simple FGR.Conclusion Prenatal ultrasound diagnosis of SUA and further examination of fetal umbilical artery with or without multiple organ malformations in the primary hospital provided an important basis for prenatal counseling and clinical treatment.In the primary hospital,if isolated SUA was found in the low risk populations,the karyotype examination was not necessary;and for other structural abnormalities associated with SUA in the fetus,it was recommended for karyotype examination in higher hospital.

关 键 词：超声 单脐动脉 先天畸形 染色体异常 基层医院 

分 类 号：R445.12[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]