孕早期超声筛查胎儿心外畸形的价值初探  

Preliminary investigation of ultrasonography sonography in screening fetal extracardiac anomaly in the first trimester

作　　者：孔凡斌[1] 宁燕[1] 严英榴[1] 赵凡桂[1] 任芸芸[1] 周毓青[1] 赵蔚[1] 孙莉[1] 

机构地区：[1]复旦大学附属妇产科医院超声科,上海市200011

出　　处：《临床超声医学杂志》2013年第10期665-667,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：目的评价孕早期超声筛查胎儿心外畸形的可行性和有效性。方法对1002例孕早期单胎妊娠胎儿行经腹超声心外畸形系统筛查,于孕中期行超声畸形复查,出生后接受新生儿体检及超声心动图检查。结果 1002例胎儿中,孕早期妊娠丢失2例,余1000例中共发现心外畸形11例,其中颈项透明层增厚并染色体异常5例(21-三体综合征3例,18-三体综合征1例,Turner综合征1例),致死性骨骼系统畸形2例,短肋多指(趾)综合征1例,脊柱裂1例,腹壁裂1例及单脐动脉1例。超声筛查的敏感性为92%(11/12),阴性预测值为98.9%(989/1000)。1例左肾缺如胎儿于中孕期复查时发现。结论孕早期超声对胎儿心外畸形进行系统筛查是可行的、有效的,结合孕中期超声筛查可提高胎儿心外畸形的检出率。Objective To evaluate the possibility and effectiveness of transabdominal sonography in screening fetal extracardiac anomaly in the first trimester. Methods A total of 1002 singleton pregnant women underwent transabdominal sonography for screening fetal extracardiac anomaly in the first trimester and were reexamined in the second trimester. The physical examination and echocardiography were performed in the newborn. Results Fetal loss taken place in 2 of 1002 pregnant women. Among the rest 1000 fetuses, fetal extracardiac anomaly was found in 11 of them, including 5 cases of thickened nuchal translucency combining with chromosome abnormality, 2 cases of fetal skeletal system deformty, 1 case of short-rib polydactyly syndrome, 1 case of spina bifida, 1 case of abdominal fissure and 1 case of single umbilical artery. The sensitivity for detecting extracardiac structural abnormalities in the first trimester was 92% （11/12） and the negative predictive value was 98.9% （989/1000）.1 case of fetal left renal agenesis was found in the second reexamination.Conclusion It is feasible and effective to screen fetal extracardiac anomaly in the first trimester by transabdominal sonography,combined with the second trimester uhrasonography can improve the detection rate of feral extraeardiac anomaly.

关 键 词：孕早期 胎儿心外畸形 超声检查 经腹 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]