四维超声筛查孕中期胎儿畸形及胎儿畸形的母体妊娠期可能因素研究  

The application of 4D ultrasound in the screening of fetal malformation in second trimester and the analysi s of possible factors of fetal malformation during pregnancy

作　　者：关三丽 乔敏霞 王君[1] 李令民[1] 郑新 GUAN San-li;QIAO Min-xia;WANG Jun(Department of Ultrasound diagnosis,Xi'an Fourth Hospital,Xi'an 710004,China)

机构地区：[1]西安市第四医院超声诊断科,陕西西安710004 [2]陕西省第四人民医院超声科,陕西西安710004

出　　处：《中国医学装备》2021年第11期90-93,共4页China Medical Equipment

基　　金：陕西省科技厅项目(2017SF-126)“四维超声在胎儿畸形筛查中的应用价值”。

摘　　要：目的:研究四维超声在孕中期胎儿畸形筛查中的应用价值及胎儿畸形的母体妊娠期可能因素。方法:选取在医院行产前超声检查的17920例孕中期孕妇,均行规范化四维超声检查,将四维超声诊断结果与引产或妊娠结果比较,计算胎儿畸形检出率,分析母体妊娠期因素对胎儿畸形的影响。结果:17920例孕中期孕妇经四维超声筛查出256例胎儿畸形,检出率为14.29‰,检出率前3位的是心血管系统、中枢神经系统及泌尿系统;四维超声筛查结果与引产或妊娠结果比较,漏诊率为1.92%。孕妇年龄≥35岁、有吸烟史、饮酒史、发热史、孕期服药史、未用叶酸以及合并妊娠期并发症均为胎儿畸形的影响因素。结论:孕中期产前行四维超声筛查胎儿畸形准确率较高,在产前胎儿畸形筛查中具有重要的临床应用价值,其中母体不良是影响胎儿畸形发生的主要因素,应给予相应的干预措施,以降低畸形儿出生率。Objective:To analyze the application value of four-dimensional(4D)ultrasound in the screening of fetal malformation during second trimester.Methods:17920 pregnant women who were in the second trimester and underwent prenatal ultrasound examination were selected.All of them underwent standardized 4D ultrasound examination.The results of 4D ultrasound diagnosis were compared with the results of induced labor or pregnancy,and the relevance ratio of fetal malformation was calculated.And then,the influence of the factors of pregnancy of materfamilias on fetal malformation was analyzed.Results:256 fetal malformations were found from 17920 pregnant women who were in the second trimester,and the relevance rate was 14.29‰.And the top three of relevance rates were cardiovascular system,central nervous system and urinary system,respectively.Compared with the results of induced labor or pregnancy,the missed diagnosis rate of the screening results of 4D ultrasound was 1.92%.The age of pregnant women≥35 years old,smoking history,drinking history,fever history,taking medication history during pregnancy,didn’t intake folic acid and combined with complications during pregnancy were the influence factors of fetal malformation.Conclusion:The accuracy rate of the screening of antenatal 4D ultrasound during second trimester is higher for fetal malformation,and it has important clinical application value in the screen of prenatal fetal malformation.Among of these influence factors,the unhealthy mother is the main factor affecting the occurrence of fetal malformation,and corresponding interventions should be implemented to reduce the birth rate of deformed children.

关 键 词：四维超声 孕中期 胎儿畸形 筛查 畸形影响因素 

分 类 号：R445.1[医药卫生—影像医学与核医学]