孕11~13周^(+6)产前超声筛查胎儿肢体畸形的价值  

Prenatal Ultrasonography for Fetal Limb Malformation Screening at 11-13^(+6)Weeks of Gestation

作　　者：何冠南[1,2] 罗红[1] 杨家翔[2] 

机构地区：[1]四川大学华西第二医院超声科,四川成都610041 [2]四川省妇幼保健院超声科,四川成都610041

出　　处：《中国医学影像学杂志》2014年第8期634-637,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨产前超声对孕11~13周+6胎儿肢体畸形的诊断价值,为早孕期诊断胎儿肢体畸形、降低缺陷儿的出生率提供依据。资料与方法 2011-06~2013-08行孕期检查的1945例孕妇,分别于孕11~13周+6及孕18~24周进行超声检查,均采用连续顺序追踪超声法检查胎儿肢体,观察肢体的形态、结构、姿势、运动等,并对分娩后新生儿及引产后胎儿进行随访。结果 1945例孕妇共有27例胎儿肢体畸形,其中孕11~13周+6检出19例,误诊1例,漏诊8例,孕11~13周+6胎儿肢体畸形的检出率为70.3%(19/27)。孕18~24周再次行超声检查,检出胎儿肢体畸形5例,修正早孕期超声诊断1例,漏诊3例。早孕期联合中孕期超声检查胎儿肢体畸形的检出率为88.8%(24/27)。结论运用连续顺序追踪超声法在早孕期对胎儿肢体进行超声检查,能够诊断大部分严重的胎儿肢体畸形,为早孕期胎儿畸形筛查的重要组成部分。Purpose To explore the value of prenatal ultrasound for the diagnosis of fetal limb malformations at 11-13 ＋6 weeks of gestation, and to provide evidence for early diagnosis of fetal limb deformities and to reduce the incidence of birth defects. Materials and Methods 1945 cases of pregnant women who had pregnancy examination from 2011-06 to 2013-08 underwent ultrasound examination at their gestational weeks of 11- 13＋6 weeks and 18-24 weeks, fetal limbs were scanned using the systematic continuous sequence approach （SCSA） to observe limb morphology, structure, posture, exercise and other abnormalities, all the newborn and induced labor fetus were followed up. Results A total of 27 cases with limb deformities were found within the 1945 fetus, among them, 19 cases were detected, 1 case was of misdiagnosed and 8 cases were missed in 11-13＋6weeks, the detection rate of limb detbrmities in 11-13＋6 weeks was 70.3% （19/27）. Another 5 cases with limb deformity were detected, 1 case was corrected and 3 cases were missed in the scan during second trimester. The detection rate of fetal limb deformities increased to 88.9% （24/27）. Conclusion Most serious fetal limb deformities could be detected by ultrasound at the first trimester using systematic continuous sequence approach, ultrasonic examination of fetal limb during early pregnancy can serve as an important part of early pregnancy screening for fetal malformation.

关 键 词：胎儿疾病 先天畸形 肢畸形 先天性 超声检查 产前 胎儿 孕龄 

分 类 号：R714.53[医药卫生—妇产科学]