规范产前超声检查诊断胎儿肢体畸形的价值

The Value of Standardized Prenatal Ultrasonography in Diagnosis of Fetal Limb Deformities

目的:探讨规范产前超声检查诊断胎儿肢体畸形的价值。材料和方法:应用彩色多普勒超声仪对2008-08～2010-08保定市妇幼保健院行产前检查的41800例孕妇按照该院胎儿超声筛查规范进行检查。筛查分四个阶段:11～14周、18～24周、25～32周和33～足月,将其中的18～24周、25～32周作为常规检查肢体的两个重要时期。使用连续顺序追踪超声法(SCSA)检测胎儿四肢,观察胎儿肢体的形态、结构、姿势、运动情况。结果:检测出肢体异常53例,胎儿肢体畸形9种(桡骨缺如5例、前臂缺失1例、四肢短小畸形11例、手缺失5例、肢体姿势异常6例、足内翻10例、双侧股骨不等长2例、下肢小腿缺如1例、多(或)并指(趾)12例,其中21例合并其他畸形。本组病例均经产后证实。结论:规范的产前超声检查是诊断胎儿肢体畸形重要的影像学诊断方法,是胎儿超声筛查质量控制体系中的重要组成部分。

Purpose To evaluate the value of standardized prenatal ultrasonography in diagnosis of fetal limb deformities.Materials and Methods During the period of August 2008 to August 2010,Color Doppler ultrasonography was used to screen 41 800 pregnant women at our hospital according to the ultrasound screening criteria of our hospital.Screening was classified into four groups：13 to 17 weeks,18 to 24 weeks,25 to 32 weeks,and 33 weeks to full-term.Groups of 18 to 24 weeks and 25 to 32 weeks were regarded as important groups of a routine fetal limb physical examination.Systematic continuous sequence approach（SCSA）with ultrasonography was used to observe the following features of fetal limbs including morphology,structure,posture and movement.Results Fetal limb abnormality was detected in 53 cases.There were nine kinds of fetal limb malformation revealed including 5 cases of radial deficiency,1 case of forearm absence,11 cases of short limbs deformity,5 cases of hand absence,6 cases of limb posture abnormalities,10 cases of talipes varus,2 cases of different length of bilateral femur,1 case of leg absence,and 12 cases of multiple fingers（toes）.Twenty-one cases complicated with other malformations.All cases of this group were confirmed by post-natal.Conclusions Standardized prenatal ultrasonography examination is an important imaging diagnostic method to detect fetal limb deformities.It is also an important part of quality control system of fetal ultrasonography screening.