孕早期畸形筛查及超声心动图检查在颈项透明层增厚胎儿中的初步应用  

Preliminary analysis of early fetal anomaly scan and fetal echocardiography in fetuses with increased nuchal translucency

作　　者：孔凡斌[1] 宁燕[1] 严英榴[1] 任芸芸[1] 孙莉[1] 赵蔚[1] 

机构地区：[1]复旦大学附属妇产科医院超声科,上海市20001

出　　处：《临床超声医学杂志》2013年第9期597-599,共3页Journal of Clinical Ultrasound in Medicine

基　　金：国家"863计划"项目资助(2007AA02Z442);上海市卫生局课题资助(2008015)

摘　　要：目的评价颈项透明层（NT）增厚且染色体正常胎儿孕早期畸形筛查及超声心动图检查的必要性。方法回顾性分析90例NT厚度t〉2．5mm且染色体正常的胎儿孕早期（孕11—13“周）超声筛查及超声心动图情况，并与该胎儿的孕中期（孕18—24周）超声筛查及超声心动图以及出生后新生儿体检的结果进行对照研究。结果90例胎儿中，共发现胎儿结构畸形12例（13％），其中孕早期发现10例，另2例结构畸形于孕中期筛查时发现。余78例胎儿孕中期超声筛查联合超声心动图检查及新生儿体检均无异常发现，与孕早期检查结果一致。孕早期超声筛查及超声心动图检查的敏感性为83％（10／12），阴性预测值为98％（78／80）。结论对NT增厚且染色体正常的胎儿进行孕早期畸形筛查及超声心动图检查是可行的、必要的，可望将某些结构畸形的检出时间提前4～8周。Objective To discuss the feasibility and necessity of early fetal echocardiography and fetal anomaly scan in fetuses with increased nuchal translucency and normal karyotype. Methods Ninety fetuses with an NT I〉2.5 mm and normal karyotype were retrospectively analyzed. Records of fetal echocardiography in the early trimester （11 ~13~6 weeks）, second trimester（ 18-24 weeks） and after birth were analyzed. Results 12 out of the 90（13%） pregnancies had a diagnosis of at least one major abnormality, 10 out of the 12 fetuses were diagnosed in the first trimester, another 2 fetuses were in the second trimester. The sensitivity for detecting structural abnormalities in the first trimester was 83%（10/12）, the negative predictive value was 98%（78/80）.Conclusion It is feasible and necessity to take early fetal echocardiography and fetal anomaly scan in fetuses with increased nuchal translucency and normal karyotype. Compare to second trimester, it can identify some kind of fetal structural malformation in first trimester.

关 键 词：超声心动描记术 颈项透明层 孕早期 筛查 胎儿 

分 类 号：R714.43[医药卫生—妇产科学] R540.45[医药卫生—临床医学]