经腹超声联合经阴道超声在判别早孕期胎儿结构异常中的临床价值  

Clinical value of transabdominal sonography combined with transvaginal sonography in the diagnosis of fetal malformations during first trimester

作　　者：梁新[1,2] 周鹏[1,2] 高露露[1,2] 刘云平[1,2] 陈书文[1,2] 

机构地区：[1]深圳大学第一附属医院 [2]深圳市第二人民医院超声科,深圳市518036

出　　处：《临床超声医学杂志》2013年第6期381-383,共3页Journal of Clinical Ultrasound in Medicine

基　　金：深圳市科技计划项目基金(201103103);深圳市医学重点学科建设经费资助(2005CD6)

摘　　要：目的探讨经腹超声联合经阴道超声在早孕期胎儿结构异常中的应用价值。方法 70例孕9～14周孕妇行经腹超声联合经阴道超声检查,分析胎儿结构异常者的声像图表现。所有结构异常者均经中孕期超声复查或引产后病理证实。结果 70例高危受检孕妇中,超声检出胎儿结构异常者27例,随访25例,失访2例。1例联体双胎漏诊,其余均与超声诊断结果一致;8例为单纯颈项透明层厚度增厚;余19例结构明显异常胎儿中,8例合并染色体异常,7例合并颈项透明层厚度增厚,4例合并水囊瘤。结论经腹超声联合经阴道超声检查提高了胎儿畸形的早期检出,对胎儿畸形早期筛查具有显著的临床价值。规范化及切面标准化是减少漏误诊的重要措施。Objective To evaluate the value and accuracy of two/three-dimensional transabdominal sonography （2D/ 3D TAS） with transvaginal sonography （TVS） in the diagnosis of fetal malformations during first trimester. Methods Seventy high-risk pregnant women at 9-14 weeks gestation underwent 2D/3D TAS and TVS. The ultrasonic characteristics of fetuses with structural abnormalities were analyzed. The structural abnormalities were confirmed by uhrasonography at second trimester or by postmortem after induction. Results Twenty-seven of 70 high-risk women showed fetal structural abnormalities. Twenty-five cases were followed up but 2 cases lost. Only one case with conjoined twins missed diagnosis. Other fetal structural abnormalities were consistent with the TAS and TVS findings. Eight cases showed single nuchal translucency thickening. Among the other fetuses with structural abnormalities, 8 of them had chromosome abnormalities, 7 of them had nuehal translucency thickening and 4 of them had hygroma. Conclusion The combination of 2D/3D TAS and TVS can improve the early detection rate of fetal structural abnormalities and has remarkable clinical value for the screening examination. Criterion examination and standardized sections are the key to reducing missed diagnosis and misdiagnosis.

关 键 词：超声检查 经腹部 经阴道 胎儿结构异常 早孕期 

分 类 号：R714.43[医药卫生—妇产科学] R445.1[医药卫生—临床医学]