产前超声筛查胎儿畸形1850例结果分析  

Analysis of 1850 cases of fetal malformation screened by prenatal ultrasound

作　　者：师晓娟[1] 石秀英[2] 张昕[1] 涂金晶 段世玲[1] 高洁[1] SHIXiao-juan;SH;ZHANG Yu;TU Jin-jing;DUAN Shi-ling;GAO Jie(Department of Ultrasound Diagnosis,Affiliated Hospital of Yah＇an University,Yan＇an,Shaanxi 716000,China;Department of Cardiovascular Disease,Affiliated Hospital of Yan＇an University,Yah＇an,Shaanxi 716000,China)

机构地区：[1]延安大学附属医院第二超声诊断科,陕西延安716000 [2]延安大学附属医院心血管分院,陕西延安716000

出　　处：《中国优生与遗传杂志》2018年第10期89-91,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的分析产前超声筛查胎儿畸形结果,为胎儿畸形筛查方案选择提供参考。方法分析2015年1月～2017年6月在本院行孕期保健的1850例孕妇临床资料,所有孕妇均于妊娠后10w内建档,并按照《中国孕前孕期保健检查规范》规定行产前保健检查。对于孕期超声筛查发现畸形者,根据畸形部位、数量、程度、对发育的影响等因素,综合考虑确定处置办法:终止妊娠、继续妊娠。并对终止妊娠胎儿行病理检查,所有胎儿出生后均行超声检查,进一步确认是否有畸形。统计产前超声诊断胎儿畸形结果(例数、畸形部位、畸胎高危因素)、处置方法、病理诊断结果、检出胎儿畸形孕周分布、超声确诊胎儿畸形所用方法,综合分析产前超声检查胎儿畸形的合理方案。结果 1850例孕妇产前超声检查共确诊胎儿畸形41例,畸形部位以神经系统、泌尿系统、心血管系统、消化系统为主。41例超声诊断胎儿畸形中,12例终止妊娠。二维超声确诊畸形26例,二维联合四维超声确诊41例。新生儿超声筛查畸形34例,其中29例与产前筛查诊断比一致,漏诊5例,漏诊率10.87%。孕18～24w检出胎儿畸形占比明显高于其他孕周段检出畸形率(P<0.05)。病理检查和新生儿筛查畸形出生缺陷的46例孕妇中43例具有畸胎高危妊娠因素,占比达93.48%。主要以遗传、母体感染、接触射线、长期接触化学物质为主。结论对有胎儿畸形高危因素的孕妇,可在规范的基础上增加产前超声检查筛查胎儿畸形的频次及增加四维超声检查,尽可能降低胎儿畸形漏诊率及出生缺陷率,提升母儿妊娠结局。Objective：To analyze the results of prenatal ultrasound screening for fetal malformation and provide a reference for the selection of fetal malformation screening. Methods：Clinical data of 1,850 pregnant women undergoing pregnancy care during the period from January 2015 to June 2017 were analyzed. All pregnant women were established within 10 weeks after pregnancy and were placed in line with the ＂Chinese Pre-pregnancy Health Check Specifications＂. Former health check. For abnormalities detected during ultrasound screening during pregnancy,factors such as malformation site,quantity,degree,and influence on development should be considered in a comprehensive manner to determine the treatment method：termination of pregnancy and continued pregnancy. The pathological examination of the fetus at the termination of pregnancy was performed. All the fetuses were subjected to ultrasound after birth to further confirm whether there was a malformation. Statistical analysis of prenatal ultrasound diagnosis of fetal malformation（number of cases,malformation sites,high risk factors for teratogenicity）,treatment methods,pathological diagnosis results,detection of fetal malformation distribution,ultrasound diagnosis of fetal malformation,comprehensive analysis of fetal prenatal ultrasound Malformed and reasonable plan. Results：A total of 41 cases of fetal malformations were diagnosed by prenatal ultrasound in 1850 pregnant women. The main malformations were nervous system,urinary system,cardiovascular system,and digestive system. Among the 41 cases of ultrasound diagnosis of fetal malformations,12 cases terminated the pregnancy. Two-dimensional ultrasound diagnosis of deformity in 26 cases,two-dimensional combined four-dimensional ultrasound diagnosis of 41 cases. There were 34 cases of neonatal ultrasound screening malformation,of which 29 cases were consistent with the prenatal screening diagnosis,5 cases were missed,and the missed diagnosis rate was 10.87%. The proportion of fetal malformations detected at 18-

关 键 词：胎儿畸形 产前超声筛查 二维超声 四维超声 孕周 漏诊 

分 类 号：R726.2[医药卫生—儿科]