超声检查诊断胎儿贫血的研究进展

Progress of Prenatal Ultrasonographic Evaluation of Fetal Anemia

产前预测胎儿宫内贫血,对指导临床干预、降低围生儿死亡率,提高围生医学质量具有重要意义。传统的产前诊断胎儿溶血性贫血的方法属于有创性检测,增加了妊娠妇女与胎儿的风险。近年来采用二维、三维及彩色多普勒超声产前诊断胎儿贫血取得了较大的进展,研究较多的指标包括胎盘厚度及体积;胎儿大脑中动脉血流峰速(MCA-PSV);胎儿心血管循环;脾动脉峰值流速;游离段脐动脉、脐静脉的内径,脐动脉搏动指数,以及肝内段脐静脉收缩期峰值血流速度;静脉导管峰值流速等。在众多超声指标中,MCA-PSV是敏感度及特异度最高的指标,联合多个指标将提高诊断的准确性。

Prenatal prediction of fetal anemia is recognized as a important contributor to guiding the clinical intervention, reducing the perinatal mortality rate and improving the quality of perinatal medicine. Traditional method of prenatal diagnosing fetal hemolytic anemia belongs to the invasive detection,which significantly increased the risks of maternal and fetuses.Recently, there are great progress and development in prenatal diagnosis for fetal anemia in accordance with application two-dimensional, three-dimensional and Doppler ultrasound. More research indicators include thickness and volume of placental, middle cerebral artery peak velocity ,fetal cardiovascular circulation, splenic artery peak velocity ,free segment of umbilical artery, umbilical vein diameter, umbilical artery pulsatility index, as well as intrahepatic umbilical vein peak velocity, velocity of ductus venosus. In the numerous index in ultrasound, fetal MCA-PSV is the best markers in sensitivity and specificity, combination of multiple indicators will improve the accuracy of diagnosis.