684例胎儿及围产儿尸检所见畸形的分析

Foetus and perinatal infants with birth defects:an autopsy analysis of 684 cases

目的了解各种先天性畸形的发生情况和顺位,分析导致先天性畸形的可能原因,为今后的孕前、孕期指导提供理论依据。方法对684例胎儿及围产期死亡儿进行尸体解剖,器官做出病理切片进行病理诊断,分析死因及各种先天性畸形的发生情况。结果进行尸检的684例中,男女之比接近1∶1。其中先天性畸形337例(49.27%),包括自然死亡49例(14.54%),引产288例(85.46%);单发畸形222例(65.88%);多发畸形115例(34.12%)。337例畸形儿共检出524畸形次,平均每例1.55畸形次,循环系统畸形所占比例最高,其次为骨骼系统、神经系统及唇腭裂。结论 2003年后心脏畸形检出率明显增长,而神经系统畸形率下降,尤其是神经系统多发畸形下降。先天性畸形是影响围产儿及胎儿死亡的重要因素。

Objective To study the incidence and rank of different birth defects and their possible causes in order to provide guidances to pregnant women for bearing and rearing better children. Methods We did autopsy and made pathological diagnosis in 684 cases of the foetus and perinatal infants to analyze the category of different malformations. Results The ratio of male to female was close to 1 ： 1 in observed 684 cases. 337 cases were examined with congenital malformation and the abnormal rate was 49.27%. Among 337 cases, the foetus suffered from the natural death were 49 （ 14. 54% ）and induced abortions were 288 （85.46%）. The eases of the single malformation were 222 （65.88%）, while the cases of multiple deformities were 115 （34. 12% ）. Malformation were detected 524 times totally in 337 cases （ 1.55 malformation times/per case）. Among these malformations, circulatory system took the first place, the second was skeletal system followed by nervous system and cleft of lip and palate, respectively. Conclusions The incidence of cardiac malformation has greatly increased since 2003 while the incidence of nervous system malformation, especially the multiple malformation in nervous system, is decreased in this study. Congenital malformation is still one of the main causes of death in perinatal infancts.