产前超声诊断胎儿单脐动脉  

Prenatal Ultrasound in the Diagnosis of Fetal Single Umbilical Artery

作　　者：段灵敏[1] 郭燕丽[1] 邓凤莲[1] 薛雅方[1] 王琰[1] 刘建君[1] 

机构地区：[1]第三军医大学第一附属医院超声科,重庆400038

出　　处：《中国医学影像学杂志》2014年第4期278-281,共4页Chinese Journal of Medical Imaging

基　　金："十一五"国家科技支撑计划项目(2006BA105A00)

摘　　要：目的评价产前超声诊断胎儿单脐动脉(SUA)左右分型的价值,为产前咨询和临床处理提供依据。资料与方法回顾性分析不同孕期接受产前筛查的489例SUA胎儿的超声特点,比较不同类型SUA合并结构畸形及胎儿结局。结果 489例SUA胎儿中,左脐动脉缺失236例(48.3%),右脐动脉缺失253例(51.7%),差异无统计学意义(P>0.05);合并胎儿先天性结构畸形223例(45.6%),其中心脏畸形100例,包括右脐动脉缺失63例、左脐动脉缺失37例;骨骼畸形92例,包括右脐动脉缺失50例、左脐动脉缺失42例;中枢神经畸形66例,包括右脐动脉缺失42例、左脐动脉缺失24例;右脐动脉缺失型单脐动脉合并心脏畸形和中枢神经畸形显著高于左脐动脉缺失(P<0.05);228例SUA胎儿终止妊娠,其中早孕期18例(78.3%),早中孕期33例(70.2%);右脐动脉缺失胎儿妊娠终止率显著高于左脐动脉缺失(P<0.05)。结论产前超声检查可以及时准确地发现SUA,并能明确其左右分型,需要进一步检查胎儿有无合并先天性结构畸形,从而指导临床进行产科处理,有利于优生优育。Purpose To evaluate prenatal ultrasound in classifying fetal single umbilical artery （SUA）, so as to provide the basis for prenatal counseling and clinical treatment. Materials and Methods The ultrasonic characteristics of 489 fetuses with SUA in different pregnancy were retrospectively analyzed. Different types of SUA combined with fetal congenital structural abnormality were compared as well as fetal outcome. Results For 489 fetuses with SUA, there were 236 cases （48.3%） with absent left umbilical artery and 253 cases （51.7%） with absent right umbilical artery. There was no statistical difference （P〉0.05）. 223 cases （45.6%） were found with fetal congenital structural abnormality, including 100 cases of cardiac malformations （absent right umbilical artery in 63 cases and absent left umbilical artery in 37 cases）, 92 cases of skeletal malformations （absent right umbilical artery 50 cases, absent left umbilical artery 42 cases） and 66 cases of central nervous system abnormalities （absent right umbilical artery 42 cases, absent left umbilical artery 24 cases）. The absent right umbilical artery combined cardiac malformation and central nerve deformity was significantly higher than the absent left umbilical artery. 228 cases with SUA fetuses were terminated pregnancy, including 18 cases （78.3%） in early pregnancy and 33 cases （70.2%） in early to mid-term pregnancy, and the absent right umbilical artery termination of pregnancy rate was significantly higher than the absent left umbilical artery （P〈0.05）. Conclusion Prenatal ultrasound diagnosis can find SUA accurately and timely, and can classify SUA to further examine whether fetuses are combined with congenital structural abnormality. The results can guide the clinical obstetric therapy and be helpful to eugenics.

关 键 词：超声检查 产前 单脐动脉 先天畸形 

分 类 号：R714.2[医药卫生—妇产科学] R445.1[医药卫生—临床医学]