产前系统超声检查对胎儿畸形筛查的临床意义

Prenatal ultrasound system for screening fetal malformations

目的 探讨产前系统超声筛查胎儿畸形的意义及导致胎儿畸形的相关因素.方法 回顾性分析2008-2009年在新疆维吾尔自治区人民医院住院分娩或引产的孕妇中胎儿畸形的发生情况,并前瞻性收集2010-2011年本我院产科门诊接受胎儿产前超声筛查、在本院住院分娩或终止妊娠孕妇的病历资料,记录孕妇年龄、不良孕产史、孕早期上呼吸道感染发热病史、在装修后半年内房室居住史和胎儿畸形分布情况.结果 产前系统筛查开展前的1 982例围产儿中畸形儿61例,漏诊率26.2%（16/61）;开展产前系统筛查后的2 056例围产儿中,畸形儿86例,漏诊率12.8%（11/86）,2组畸形儿漏诊率比较.接受产前系统超声筛查的畸形儿组孕妇年龄≥35岁、有不良孕产史、孕早期有上呼吸道感染发热病史、孕早期在半年内装修房屋居住史者均多于非畸形儿组,差异有统计学意义[26.7%（23/86）比16.4%（323/1 970）、86.0%（74/86）比6.2%（123/1 970）、62.8%（54/86）比18.1%（356/1 970）、26.7%（23/86）比18.2%（358/1 970）,均P〈0.01].结论 孕中期孕妇进行常规系统超声筛查,能及时发现大多数胎儿畸形.孕妇年龄≥35岁、有不良孕产史、孕期有上呼吸道感染发热病史、孕早期在装修房屋半年内居住史可能是导致胎儿畸形的高危因素.

Objective To investigate the significance of prenatal ultrasound system screening fetal malformations. Methods We retrospectively collected fetal malformation in 2008-2009 in pregnant women. Results Totally 2 056 pregnant women received the prenatal systematic screening; there were 86 cases of deformed children with a misdiagnosis rate of 12.8% （11/86）. Age〉 35 years, history of adverse pregnancy, cold and fever during pregnancy, living renovated house within six months in early pregnancy were significant risk factors[26.7%（23/86） vs 16.4%（323/1 970）,86.0%（74/86） vs 6.2%（123/1 970）,62.8%（54/86） vs 18.1%（356/1 970）,26.7%（23/86） vs 18.2%（358/1 970）, all P〈0.01]. Conclusions Ultrasound screening system can find most fetal malformations. Maternal age〉35 years, history of adverse pregnancy, cold and fever during pregnancy and living renovated house within six months in early pregnancy may cause fetal malformation.