早、中孕联合超声筛查诊断胎儿异常  

Combination prenatal ultrasound screening in early and middle stage of pregnancy for detecting fetal abnormalities

作　　者：顾燕[1,2] 胡娅莉[1,2] 茹彤[1,2] 杨燕[1,2] 戴晨燕[1,2] 杨丽娟[1,2] 

机构地区：[1]南京鼓楼医院 [2]南京大学医学院附属鼓楼医院产前诊断中心,江苏南京210008

出　　处：《中国医学影像技术》2011年第10期2087-2090,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家"十一五"科技支撑计划课题项目(2006BAI05A04)

摘　　要：目的评估早、中孕联合超声筛查诊断胎儿异常的临床价值。方法对2844名孕11～13+6周的孕妇(共3135胎)行孕早期超声筛查,测量颈项透明层厚度(NT),重点观察胎儿颅脑横切面,多切面观察胎儿主要脏器及形态结构。对继续妊娠的2865胎,在孕18～24周行孕中期胎儿结构筛查;孕32周超声监测胎儿生长发育。对所有新生儿进行随访。结果孕早期超声筛查在3135胎中检出153胎(153/3135,4.88%)异常,包括NT增厚20胎、胎儿水肿25胎、胎死宫内75胎、露脑畸形9胎、脐疝2胎、巨膀胱2胎、肢体发育异常2胎、多发畸形5胎、联体双胎1胎、单脐动脉12胎。孕中期超声筛查在2865胎中检出66胎(66/2865,2.30%)异常,包括胎儿水肿6胎、中枢神经系统异常13胎、颜面部畸形3胎、心脏异常11胎、膈疝1胎、脐疝2胎、肢体异常1胎、泌尿系统异常9胎、多发畸形1胎、胎儿生长受限5胎、脐带异常14胎。结论孕早期超声筛查能早期检出部分严重、早发的胎儿异常,但不能替代孕中期超声筛查。Objective To observe the clinical value of combined ultrasound screening for abnormal fetuses during the first and second trimesters.Methods A total of 2844 pregnant women（3135 fetuses） underwent ultrasound scan between 11—13＋6 weeks of gestation.The thickness of fetal nuchal translucency（NT） was measured,and fetal major anatomy structures were observed specially on cross-sectional view of the fetal brain.In 18—24 weeks of gestation,2865 fetuses in the same group accepted multi-section ultrasound screening test for fetal systematic examination,and fetal growth situation was followed in 32 weeks of gestation.All the neonates were followed up.Results In the first trimester,there were 153 abnormal fetuses among 3135 fetuses（4.88%）,including NT ≥3.0 mm in 20 fetuses,fetal hydrops in 25,dead fetus in uterus in 75,acrania in 9,umbilical hernia in 2,megabladder in 2,limb abnormalities in 2,multiple malformations in 5,conjoined twins in 1 and single umbilical artery in 12 fetuses.In the second trimester of the same group,there were 66 abnormal fetuses identified among 2865 fetuses（66/2865,2.30%）,including 6 fetal edema,13 gentral nervous system abnormalities,3 facial deformity,11 cardiac defect,1 diaphragmatic hernia,2 umbilical hernia,1 limb abnormalities,9 urinary system abnormalities,1 multiple malformations,5 fetal growth restriction and 14 abnormal umbilical cord.Conclusion Ultrasound screening in the first trimester can effectively detect the abnormal fetuses in some degree,but the second trimester screening is still necessary.

关 键 词：超声检查 产前 先天畸形 颈项透明层 

分 类 号：R714.53[医药卫生—妇产科学] R445.1[医药卫生—临床医学]