妊娠期多病原体感染胎儿产前超声的临床诊断分析

Effect of prenatal ultrasound on clinical diagnosis of multiple pathogens infections in fetuses during pregnancy

目的观察产前超声对于妊娠期多病原体感染胎儿的临床诊断效果,为提高医院临床诊断多病原体感染胎儿提供依据。方法选取2012年1月-2015年1月300例在医院经ELISA法检测弓形体(TOX)、风疹病毒(RV)、巨细胞病毒(CMV)及单纯疱疹病毒(HSV)特异性抗体IgM阳性孕妇进行超声诊断,观察孕妇胎儿超声诊断图像特征以及胎儿结局;采用SPSS16.0软件进行统计分析。结果 300例孕妇中有31例超声诊断有异常表现;6例TOX感染孕妇超声表现为羊水量较多、肾窦异常、肝内钙化灶、颅内钙化灶、脑积水,其中胎儿结局为引产、胎儿死亡、早产各1例,其余新生儿无异常;16例RV感染孕妇超声表现为羊水量较多或较少、肾窦异常、肠回声异常、脑积水、颈部淋巴水囊瘤、室间隔缺损,胎儿结局为4例引产、2例胎儿死亡、3例早产,其余新生儿无异常;4例CMV感染孕妇超声表现为肠回声异常、胎盘异位、胎盘钙化,胎儿结局为2例早产、其余新生儿无异常;5例HSV感染孕妇超声表现为肾窦异常、肠回声异常、脐动脉异常,胎儿结局为引产、早产各1例、其余新生儿无异常。结论通过产前超声诊断能够发现病原体感染导致胎儿出现各种图像学诊断特征,能够为孕妇咨询以及处理起到有效的辅助诊断作用。

OBJECTIVE To observe the effect of prenatal ultrasound on clinical diagnosis of multiple pathogens infections in fetuses during pregnancy so as to provide guidance in the clinical diagnosis of the fetuses with multiple pathogens infections.METHODS From Jan 2012 to Jan 2015,totally 300 pregnant women who were tested positive for the specific antibody IgM for toxoplasm（TOX）,rubella virus（RV）,cytomegalovirus（CMV）,and herpes simplex virus（HSV）by ELISA were enrolled in the study,then the ultrasonic diagnosis was carried,the ultrasound image features of the fetuses and pregnancy outcomes were observed,and the statistical analysis was performed with the use of SPSS16.0software.RESULTS The ultrasound diagnosis was shown abnormal in 13 of 300pregnant women.The ultrasound of 6pregnant women with TOX infection was characterized by the large volume of amniotic fluid,abnormal renal sinus,intrahepatic calcification,and hydrocephalus;the fetal outcomes included1 case of induced labor,1case of death,and 1case of premature delivery;the rest of neonates were normal.The ultrasound of 16 pregnant women with RV infection was characterized by the large or less volume of amniotic fluid,abnormal renal sinus,abnormal bowel echo,hydrocephalus,cervical lymphatic hygroma,and ventricular defect;the fetal outcomes included 4cases of induced labor,2cases of death,and 3cases of premature delivery;the rest of neonates were normal.The ultrasound of 4pregnant women with CMV infection was characterized by abnormal bowel echo,ectopic placenta,and placental calcification;the fetal outcome was 2case of premature delivery;the rest of neonates were normal.The ultrasound of 5pregnant women with HSV infection was characterized by abnormal renal sinus,abnormal bowel echo,and abnormal umbilical artery;the fetal outcomes included 1case of induced labor and 1case of premature delivery;the rest of neonates were normal.CONCLUSIONThe prenatal ultrasound diagnosis can find a variety of image features of the fetuses with pathogenic bacteria infections,which may offer advice for the pregnant women and play a role of auxiliary diagnosis.