体外受精-胚胎移植胎儿心外畸形的产前超声表现及分类特征

Ultrasonographic manifestations and classification features of extracardiac anomaly for in vitro fertilization-embryo transfer fetuses

目的探讨体外受精-胚胎移植(IVF-ET)的妊娠胎儿心外畸形的超声声像图表现及分类特征。方法选取2010年1月至2013年9月在南京军区福州总医院行产前系统超声检查的IVF-ET妊娠孕妇1 022例,分析IVF-ET妊娠胎儿心外畸形的超声表现及分类特征,并追踪所有孕妇的妊娠过程及临床结局。结果 1 022例接受IVF-ET的孕妇中单胎妊娠879例、双胎妊娠143例,共检测胎儿1 165例,产前检出胎儿各种心外畸形14例(1.2%,14/1 165)。其中颜面部畸形3例(唇腭裂3例,其中1例合并食道闭锁),泌尿系统畸形3例(肾积水1例、双肾盂1例、一侧肾缺如伴另一侧异位肾1例),胸腔畸形3例(胸腔积液1例、膈疝2例),消化系统畸形2例(永久性右脐静脉1例、食道闭锁1例),神经系统畸形1例(脑积水),淋巴系统发育异常1例(颈部水囊状淋巴管瘤)、骨骼系统畸形1例(足内翻)、双胎输血综合征1例。结论产前系统超声检查能全面系统评价IVF-ET妊娠胎儿心外畸形的情况,为客观评价IVF-ET胎儿出生缺陷提供重要依据。

Objective To evaluate the ultrasonographic manifestations and classification features of extracardiac anomaly for in vitro fertilization-embryo transfer（IVF-ET） fetuses. Methods Routine prenatal ultrasound screening was performed on 1 022 pregnant women during 18～24 gestational weeks from Jan. 2010 to Sep. 2013. The ultrasound image features and classification features of extracardiac anomaly for IVF-ET fetuses were analyzed. The pregnant process and clinical outcome of pregnancy were tracked. Results Among the 1 022 fetuses, there were 879 cases of single pregnancy and 143 cases of gemellary pregnancy. Among the 1 165 fetus obtained prenatal ultrasound screening, there were 14 cases of fetal malformations（1.2%, 14/1 165）, including 3 cases of facial deformity（3 cases of cheilopalatognathus, including one case of esophageal atresia）, 3 cases of urinary system abnormalities（1 case of hydronephrosis, 1 case of double renal pelvisin, 1 case of lack of right kidney with left renal dysplasia）, 3 cases of thoracic deformity（1 case of pleural effusion, 2 cases of diaphragmatic hernia）, 2 cases of digestive system abnormalities（1 case of persistent right umbilical vein, 1 case of esophageal atresia）, 1 case of nervous system malformation（moderate hydrocephalus）, 1 case of lymphatic system abnormity（cystic hygroma of the neck）, 1 case of skeletal system deformity（clubfoot deformity）, and 1 case of twins transfusion syndrome. Conclusion Prenatal ultrasonography can give a systematic and comprehensive evaluation of fetal extracardiac anomaly in IVF-ET pregnancy and provide important evidence for fetal birth defects.