产前超声在妊娠期多病原体感染胎儿诊断中的应用  

The application of prenatal ultrasound in pregnancy with several kinds of pathogen infection

作　　者：孙玲玲[1] 邓学东[1] 梁泓[1] 凌晨[1] 吴凤钰[1] 殷林亮[1] 潘琦[1] 

机构地区：[1]南京医科大学附属苏州医院苏州市立医院超声中心,215002

出　　处：《中华医学超声杂志（电子版）》2014年第7期41-45,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨妊娠期感染弓形体(TOX)、风疹病毒(RV)、巨细胞病毒(CMV)及单纯疱疹病毒(HSV)胎儿异常超声声像图特征。方法对2011年1月至2013年3月在南京医科大学附属苏州医院苏州市立医院经免疫吸附法(ELISA)检出血清弓形体、风疹病毒、巨细胞病毒及单纯疱疹病毒特异性抗体IgM阳性孕妇的545例胎儿进行产前超声检查,总结胎儿异常超声声像图特征并随访妊娠结局。结果 545例胎儿产前超声检出异常超声表现56例,包括中枢神经系统异常6例(颅内钙化灶2例、脑积水4例);消化系统异常9例(肝内钙化灶1例、肠管回声增强8例);心脏异常2例(室间隔缺损1例、右心增大1例);羊水量异常17例(羊水过多16例、羊水过少1例);胎盘异常3例(胎盘过厚1例、胎盘异常钙化2例);泌尿系统异常13例,表现为肾窦分离;其他系统异常6例(淋巴水囊瘤1例、单脐动脉1例、骶尾部畸胎瘤1例及胎儿宫内生长受限3例),2例胎儿为复杂畸形。56例胎儿中7例超声检查后孕妇选择引产,3例胎儿早产,2例胎死宫内,余44例随访至出生未发现其他异常。结论产前超声可发现妊娠期病原体感染所致脑积水、心脏异常等胎儿严重畸形以及颅内钙化灶、肠管回声增强、胎盘异常钙化等特征性表现,可为孕妇产前咨询和临床进一步处理提供诊断依据。Objective To investigate the fetal ultrasonographic features in pregnancies with Toxoplasma （TOX）, rubella virus （RV）, cytomegalovirus （CMV） and herpes simplex virus （HSV） infection. Methods From January 2011 to March 2013, prenatal ultrasound examination was performed in 545 fetuses with mothers of specific positive IgM of TOX, RV, CMV and HSV, detected by enzyme-linked immune sorbent assay （ELISA） in Nanjing Medical University Affiliated Suzhou Hospital. Ultrasonographic features were summarized and pregnancy outcome was followed up in fetuses with abnormal findings. Results Among the 545 fetuses, 56 cases with abnormal sonographic findings： 6 cases with central nervous systerm abnormalities （2 intracranial calcifications, 4 hydrocephaly）; 9 cases with digestive system abnormalities （1 intrahepatic calcifications, 8 echogenic bowel）; 2 cases with heart abnormalities （1 interventricular septal defect, 1 right heart enlargement）; 17 cases with abnormal amniotic fluid volume （16 polyhydramnios, 1 oligohydramnios）; 3 cases with placental abnormality （1 thick placenta, 2 placenta abnormal calcification）; 13 cases with ttdnary systerm abmormality appearing as renal sinus separation; and 6 cases with other systerm abnormalities （1 neck lymphatic hygroma, 1 single umbilical artery, 1 sacrococygeal teratoma and 3 intrauterine growth restriction）; 2 cases of complicated abnormalities. Conelusions Prenatal ultmsonography is significant in detecting serious fetal malformations, such as hydrocephaly, heart abnormalities and characteristic ultrasound features such as intracmnial calcifications, echogenic bowel, placenta abnormal calcification complicated with TOX, RV, CMV and HSV infection, providing valuable information for further clinical treamaent, such as induced labour.

关 键 词：超声检查 产前 胎儿 感染 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]