二维联合四维超声对产前胎儿畸形的筛查及诊断

The Value of Two-dimensional Ultrasound Combined with Four-dimensional Ultrasound in Prenatal Fetal Malformation Screening and Diagnosis

目的:探讨二维联合四维超声对产前胎儿畸形筛查及诊断价值。方法:选取产前检查疑似妊娠畸形胎儿的800例孕妇,均行二维、四维超声检查,以分娩胎儿结局为标准,分别评价二维超声、四维超声、二维联合四维超声检查方式对畸形胎儿的检出率、敏感性、特异性及准确性。结果:终止妊娠时,有畸形胎儿261例(32.63%),二维超声及四维超声的畸形儿检出率明显低于二维联合四维超声(χ2=7.427,P<0.05),二维联合四维超声诊断的敏感性、特异性及准确性均高于二维超声和四维超声诊断(χ2=8.279、7.464、7.028,P<0.05),二维联合四维超声产前诊断不同类型胎儿畸形的检出率明显高于二维和四维超声(P<0.05)。结论:二维联合四维超声可提高产前胎儿畸形检出率,优于单一的二维超声检查或四维超声检查。

Objective： To study the value of two-dimensional ultrasound combined with four-dimensional ultrasound in prenatal fetal malformation screening and diagnosis Methods： A total of 800 cases of pregnant women with suspected pregnancy malformation were examined by two-dimensional and fourdimensional ultrasound. The detection rate,sensitivity,specificity and accuracy of two-dimensional ultrasound,four-dimensional ultrasound and two-dimensional combined with four-dimensional ultrasound were compared by using fetal outcome as diagnosis standard. Results： There were 261 cases of malformed fetus in termination of pregnancy. The fetal malformation detection rate of two dimensional ultrasound and four dimensional ultrasound was significantly lower than that of two dimensional combined with four dimensional ultrasound（ χ2= 7. 427,P〈 0. 05）. The sensitivity,specificity and accuracy of two-dimensional ultrasound combined with four-dimensional ultrasound were significantly higher than two-dimensional ultrasound and four-dimensional ultrasound（ χ2= 8. 279、7. 464、7. 028,P 〈0. 05）.The detection rate of different type of fetal malformation of two-dimensional ultrasound combined with four-dimensional ultrasound were significantly higher than two-dimensional ultrasound and four-dimensional ultrasound（ P〈 0. 05）. Conclusion： Two dimensional ultrasound combined with four-dimensional ultrasound can improve the detection rate of prenatal fetal malformation,which is better than a single two-dimensional ultrasound examination or four dimensional ultrasound examination.