引产儿高频超声与产前超声及产后尸解病理结果的对比研究

The Comparative Study of High-frequency Ultrasound and Prenatal Ultrasound and Postnatal Autopsy Pathology for Aborted Fetuses

目的:探究引产儿尸体高频超声检查的实用价值及评价产前超声诊断准确率。方法:对2008年9月-2013年1月在本院产前超声检查诊断为严重畸形,父母决定引产并同意尸体解剖的20例引产儿的尸体行高频超声检查并行尸体解剖病理检查,比较产前、产后超声检查及尸解病理结果。结果:20例异常胎儿中,产前超声发现结构畸形30处,高频超声检出结构畸形38处,尸检共畸形40处,产前超声检查结果与高频超声结果符合率为78.9%(30/38)。产后高频超声与尸检结果符合率为95.0%(38/40)。结论:产前超声发现胎儿畸形的灵敏度较高,但对畸形的归属能力的判断还有待进一步提高,产后高频超声检查与尸体解剖结果符合率较高,在尸检被拒绝时,引产儿产后高频超声检查是有效可行的替代尸检方法。

Objective：To explore the practical value of the high-frequency ultrasound examination for aborted fetuses and evaluate the diagnostic accuracy of prenatal ultrasound. Method：The high-frequency ultrasound examination and autopsy pathological examination were used for 20 cases of aborted fetuses with diagnosed of severe deformity by prenatal ultrasound and agreed with parents in the hospital from September 2008 to January 2013, and compared the results of prenatal ultrasound with the results of postnatal ultrasound examination and autopsy pathological examination. Result：Among 20 cases of abnormal fetuses,30 structural malformations were found by prenatal ultrasound,38 structural malformations were detected by high-frequency ultrasound,40 deformities were found by autopsy pathological examination. The accordance rate of prenatal ultrasound findings and high-frequency ultrasound examination 78.9%（30/38）,and the agreement rate of high-frequency ultrasound and postnatal autopsy results was 95%（38/40）. Conclusion：The sensitivity of prenatal ultrasound is higher in detecting fetal malformations,however,the ability to determine the location of deformity to be further improve. The accordance rate of prenatal ultrasound and autopsy pathology is higher. The postnatal high-frequency ultrasound may be an effective and feasible alternative method of autopsy for aborted fetuses when the autopsy is denied.