孕早期羊膜带综合征的产前超声诊断  

Prenatal ultrasound diagnosis of amniotic band syndrome in the first trimester

作　　者：梁娜[1] 张铁娟[1] 韩吉晶[1] 马雪松[1] 王莉[1] Liang Na;Zhang Tiejuan;Han Jijing;Ma Xuesong;Wang Li(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院超声科,北京100026

出　　处：《中华超声影像学杂志》2024年第8期683-687,共5页Chinese Journal of Ultrasonography

摘　　要：目的总结孕早期羊膜带综合征(ABS)胎儿畸形的产前超声特点,以期能够提高该疾病的超声检出率。方法回顾性分析2017年1月至2023年10月于北京妇产医院进行系统孕早期胎儿畸形超声筛查的孕妇,收集到超声诊断并有引产结果证实的孕早期ABS病例23例,包括其临床资料、图像和检查结果,总结孕早期ABS超声声像图特征。结果23例病例超声检查均显示宫内羊膜带与胎儿受累部位的粘连,各病例的畸形均不相同,与胎儿不同体表部位受损紧密相关。胎儿多发畸形占78%(18/23),单发仅占22%(5/23);23例中累及胎儿肢体19例(83%),颅脑11例(48%),胸腹壁11例(48%),脊柱10例(43%),颜面5例(22%),脐带5例(22%)。23例(100%)引产后均被证实为ABS,与超声诊断相符,但其中11例(48%)超声未精准描述出胎儿肢体或颜面部的异常。结论孕早期ABS的胎儿畸形与羊膜带密不可分,具有多发性、独特性、随机性和不对称性的特点,最多累及的是胎儿肢体、颅脑和体壁,严重畸形多见,产前超声可提示性诊断。Objective To summarize the prenatal ultrasound characteristics of fetal malformations with amniotic band syndrome(ABS)in early pregnancy,in order to improve the ultrasound detection rate of this disease.Methods Pregnant women who underwent systematic ultrasound screening of early pregnancy fetal malformations in Beijing Obstetrics and Gynecology Hospital from January 2017 to October 2023 were retrospectively collected.Twenty-three cases of early pregnancy ABS were collected and confirmed by ultrasound diagnosis and induced abortion results.Clinical data,images,and examination results of these cases were studied and the ultrasound characteristics of early pregnancy ABS were summarized.Results In all 23 cases,adhesions between the intrauterine amniotic band and the affected parts of the fetus were found during ultrasonography,and the malformations in each case were different and closely related to the damage to different body surface parts of the fetus.Multiple fetal malformations accounted for 78%(18/23)and single cases accounted for only 22%(5/23).Among the 23 cases,19(83%)involved fetal limbs,11(48%)brains,11(48%)thoracic and abdominal walls,10(43%)spine,5(22%)faces,and 5(22%)umbilical cords.23(100%)patients were confirmed to have ABS after induction of labor,which was consistent with the ultrasound diagnosis,but 11(48%)of them did not accurately describe fetal limb or facial abnormalities.Conclusions The fetal malformation of ABS in the first trimester is closely related to the amniotic band,which has the characteristics of multiple properties,uniqueness,randomness and asymmetry.The most affected parts are the fetal limbs,brain,and body wall,and severe malformations are common.Prenatal ultrasound can provide suggestive diagnosis.

关 键 词：超声检查 产前 羊膜带综合征 孕早期 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]