产前胎儿超声检查风险防范浅探

Probe into the Risk Prevention of Prenatal Ultrasound Examination

目的探讨产前胎儿超声检查风险防范的方法,提高产前胎儿畸形诊断率,降低漏诊率,减少医疗纠纷。方法对2010年1月至2010年12月在宜昌市第三人民医院及枝江市人民医院就诊的1426例中期妊娠患者使用西门子ACUSON-Antares彩色多普勒超声诊断仪进行产前常规超声检查。①所有孕妇在检查前签署一份"知情同意书",内容包括产科超声检查规范的四个层次、超声检查的安全性、局限性及风险告知;②按照分类检查要求进行规范化及程序化的产前胎儿常规超声检查,显示的主要切面图像采集于工作站中,以备复查。结果 1426例中超声诊断胎儿畸形7例,避免医疗纠纷1例。使用该方法检查胎儿畸形诊断率明显提高,漏诊率降低,医疗纠纷基本消失。结论医院在产前胎儿超声检查中签署知情同意书,实行规范化及程序化产前超声检查对提高产前胎儿畸形诊断率、降低漏诊率,最大限度防范医疗风险,具有重要的临床意义。

Objective To discuss fetal risk prevention methods of prenatal ultrasonography,to increase the rate of prenatal diagnosis of fetal abnormalities,reduce the rate of misdiagnosis,and reduce medical disputes.Methods During Jan.2010 and Dec.2010,1426 cases of pregnancy from Yichang City Third People＇s Hospital took the Siemens ACUSON-Antares color Doppler ultrasonic prenatal ultrasound examination.① all pregnant women signed a ＂ consent ＂,including four evels of obstetric ultrasonography code,ultrasound examination safety,inform limitations and risks;② classification in accordance with the inspection requirements for standardization and proceduralization of prenatal ultrasound examination,main aspects of image captured at workstation,for review.Results Among the 1426 cases,there were 7 cases of ultrasonographic diagnosed fetal malformation,avoiding 1 case of medical dispute.Using this method the fetal malformation diagnosis rate increased significantly,missed diagnosis decreased,and medical dispute basically disappeared.Conclusion Signing informed consent form in a prenatal ultrasound examination,implementing standardized and programmed prenatal ultrasound examination are of great clinical signficance for improving prenatal diagnosis of fetal malformation rates,reducing the rate of missed diagnosis,maximize the prevention from the medical risks.