产前二级超声筛查对减少胎儿出生缺陷的价值

Value of fetal prenatal secondary ultrasound screening for reducing fetal birth defects

目的研究二级超声筛查在胎儿出生缺陷诊断中的应用价值,为预防出生缺陷提供依据,促进优生优育。方法回顾性分析2013年2月至2017年1月于中山市东升医院围产保健门诊进行超声检查的400例孕妇(405例胎儿)的检查资料,以引产、分娩或专科证实存在先天性畸形为标准,统计分析二级超声检查在胎儿出生缺陷中的诊断价值。结果本组胎儿出生缺陷率为2.72%(11/405),二级超声检查显示胎儿出生缺陷检出率为81.82%(9/11),漏诊率为18.18%(2/11);ROC分析结果示,二级超声诊断胎儿出生缺陷AUC为0.912(95%CI:0.168~0.958),灵敏度为92%、特异度为90%、准确度为95%、阳性预测值为93%、阴性预测值为94%。结论二级超声可准确检出胎儿出生缺陷,在产前胎儿出生缺陷筛查中有较高的应用价值。

Objective To study the clinical value of secondary ultrasound in the diagnosis of birth defects in the fetus, to provide evidence for the prevention of birth defects and promote eugenics. Methods The clinical data of400 cases（405 fetuses） of perinatal pregnant women, who underwent ultrasound screening at perinatal health care of section for outpatients in Zhongshan Dongsheng Hospital from February 2013 to January 2017, were retrospectively analyzed. The presence of congenital malformations determined by abortion, production or specialist taking as the standard,the ultrasound diagnosis value for birth defects in the fetus were analyzed. Results There was 2.72% of birth defects in fetuses（11/405）. The detection rate of birth defects for secondary fetal ultrasound was 81.82%（9/11）, with the missed diagnosis rate of 18.18%（2/11）. ROC analysis showed that the AUC of fetal birth defects for secondary ultrasound was 0.912（95%CI： 0.168-0.958）, with the sensitivity of 92%, specificity of 90%, accuracy of 95%, positive predictive value of 93%, negative predictive value of 94%. Conclusion Secondary ultrasound can accurately detect fetal birth defects and has a high value in screening prenatal fetal birth defects.