不同孕周产前超声诊断胎儿畸形的临床价值

Clinical value of ultrasound on the prenatal diagnosis of fetal malformation at different gestational age

目的 探讨不同孕周超声诊断胎儿畸形的临床价值。方法 根据不同孕周11-13＋6w、22-24w、28-40w实施阶段性超声筛查,对胎儿结构异常做出诊断,并与产后或尸解结果对照。结果 6217例胎儿产前超声筛查检出胎儿畸形共计112例（其中复合畸形12例）125项畸形,引产及分娩后证实胎儿畸形129项。未检出的4项胎儿畸形分别为：praderwilli综合征1例,肛门闭锁1例,室缺1例,外耳道畸形1例。孕早、中、晚孕期筛查占超声筛查结构异常胎儿的比例分别为16.0%、54.4%、29.6%。孕早期超声筛查出胎儿畸形以中枢神经系统畸形为主。孕中期筛查检出的胎儿畸形以心血管系统畸形为主,其次为颜面部畸形。孕晚期筛查检出的胎儿畸形是肾积水占首位,其次为胎儿肿瘤及异常囊性结构。结论 早、中、晚孕期不同,可出现结构异常的胎儿畸形不同,只有掌握了各个孕期可能出现的畸形,才能提高产前超声胎儿畸形检出率。

Objective： To evaluate the value of ultrasound on the prenatal diagnosis of fetal malformationat different gestational age. Methods： Screening was carried out in women at 11- 13-8, 22-24 to 28-40 week＇ s gestation. Results： 112 fetal malformation cases （ 100 one-malformation cases and 12complicated-malformation cases） out of 6217 fetuses were detected by ultrasound. 129 cases had been confirmed by induced labor or post partum. 4 fetal malformation cases were missed by diagnosis, they were 1 case of prader-willi syndrome, 1 case of anal atresia, 1 case of ventricular septal defect, 1 case of external auditory canal malformation.The proportion of fetal malformation cases at each gestational age to all fetal malformation cases were 16.0%, 54.4%, 29.6%respectively.Central nervous system malformation is the main reason in early pregnancy.Cardiovascular malformation is the main reason in middle pregnancy, followed by facial deformity.Hydronephrosis is the main reason in late pregnancy, followed by fetal tumors and abnormal cystic structure. Conclusions： Early, middle and late pregnancy is different, there may be structural abnormalities of fetal malformations is different.Only by mastering the various abnormalities that may occur during ever pregnancy, we can improve the detection rate of fetal malformations by ultrasonography.