早孕期规范化超声检查在胎儿畸形筛查中的应用效果观察

Observation of the effect of standardized ultrasound examination in the screening of fetal malformation during early pregnancy

目的 探究早孕期规范化超声检查在胎儿畸形筛查中的应用效果.方法 抽取2014年10月至2015年10月行胎儿畸形筛查孕妇986例,所有研究对象均行规范化超声检查,向检出胎儿畸形的病例开展优生遗传咨询,根据孕妇意愿决定是否继续妊娠或引产,若选择继续妊娠则对其进行随访,明确其妊娠结局与新生儿情况.根据引产结果或随访结果统计早孕期超声诊断准确率.结果 986例孕妇中共出现27例胎儿畸形,经超声检查共检测出25例,检出率为2.54%（25/986）,与随访或引产结果[2.74%（27/986）]比较差异未见统计学意义（P〉0.05）,超声检查准确率为92.59%（25/27）,其中唇腭裂0.81%（8/986）、露脑畸形0.20%（2/986）、心脏结构异常0.10%（1/986）、下肢发育异常0.31%（3/986）、颈部水囊瘤0.41%（4/986）、脊柱侧弯0.20%（2/986）、无脑儿0.51%（5/986）.结论 于早孕期对孕妇实施规范化超声检查可有效检测出胎儿畸形情况,诊断准确率较高,可为干预方案的制定提供指导依据,降低畸形儿出生率,具有推广价值.

Objective To investigate the application effect of standardized ultrasound examination in the screening of fetal malformation during early pregnancy.Methods Nine hundred and eighty-six cases of pregnant women with fetal malformation were selected from October 2014 to October 2015.All study subjects underwent standardized ultrasound examination;The prepotency consultation cases of fetal abnormalities were check out.In accordance with the wishes of pregnant women,they decided whether to continue pregnancy or labor induction,if they chose to continue pregnancy,made them understand the pregnancy outcome and neonatal condition clearly.According to the results of induced labor or follow-up results,the accuracy of ultrasound diagnosis in early pregnancy were counted.Results There were 27 cases of fetal malformation in 986 cases of pregnant women,25 cases were examined by ultrasonography,the detection rate was 2.54% （25/986）.Compared to 2.74% with follow-up results or abortion （27/986）,there was no significant difference （P〉0.05）.The accuracy rate of ultrasound was 92.59% （25/27）,of which cleft lip and palate accounted for 0.81% （8/986）,exencephalia accounted for 0.20% （2/986）,cardiac structural abnormalitie accounted for 0.10% （1/986）,lower limb dysplasia accounted for 0.31% （3/986）,cystic hygroma accounted for 0.41% （4/986）,scoliosis accounted for 0.20% （2/986）,no brain accounted for 0.51%（5/986）.Conclusions The standardized ultrasound examination of pregnant women in early pregnancy can effectively detect fetal malformations,and the diagnostic accuracy is high.It can provide guidance for the formulation of intervention program and reduce the birth rate of deformed children.