系统产前超声检查在双胎妊娠产前筛查中的应用价值

Application value of systematic prenatal ultrasound in prenatal screening of twin pregnancy

目的探讨系统产前超声检查在双胎妊娠产前筛查中的应用价值。方法对2012年10月至2017年12月在咸阳市妇幼保健院进行系统产前超声检查的393例双胎妊娠资料进行回顾性分析,将其中27例双胎妊娠畸形病例纳入研究。通过将双胎妊娠畸形病例产前超声检查资料与随访及病理解剖结果进行对比,分析双胎妊娠系统产前超声检查胎儿畸形检出率及诊断符合率。结果纳入研究的27例双胎妊娠畸形病例中19例为胎儿结构畸形,8例为双胎妊娠特有畸形。19例胎儿结构畸形均为双胎之一胎儿的单一畸形,8例双胎妊娠特有畸形多为两个胎儿同时受到累及。系统产前超声检查检出17例胎儿结构畸形和8例双胎妊娠特有畸形均与病理诊断符合,系统产前超声检查诊断符合率100%(25/25);漏诊胎儿结构畸形2例,胎儿畸形检出率92.6%(25/27)。结论系统产前超声检查应用于双胎妊娠产前筛查有较高的畸形检出率及诊断符合率,具有重要的临床应用价值。

Objective To explore the application value of systematic prenatal ultrasound in prenatal screening of twin pregnancy. Methods Retrospectively analyzed 393 cases of twin pregnancy who underwent systematic prenatal ultrasound examination in our hospital from October 2012 to December 2017, and 27 cases of twin pregnancy malformation were included in the study. By comparing the data of prenatal ultrasound examination with follow-up data and pathological anatomic results, the detection rate and diagnostic coincidence rate of fetal malformation in prenatal screening of twin pregnancy by systematic prenatal ultrasound examination were analyzed. Results Among 27 cases of twin pregnancy malformation, 19 cases were fetal structural malformation and 8 cases were unique malformation of twin pregnancy. Nineteen cases of twin pregnancy fetal structural malformation occurred in one of the two fetuses in twin pregnancies, and all of which were single malformations. Eight cases of unique malformation of twin pregnancy were often involved in double fetuses. Seventeen cases of fetal structural abnormalities and 8 cases of unique malformation of twin pregnancy were diagnosed correctly by systematic prenatal ultrasound examination, and the diagnostic coincidence rate of prenatal ultrasound was 100%（25/25）. Two cases of structural malformation were missed, and the detection rate of fetal malformation was 92.6%（25/27）. Conclusion The systematic prenatal ultrasound in prenatal screening of twin pregnancy has high detection rate of malformation and diagnostic coincidence rate, which has important clinical application value.