孕11～13^(+6)周超声规范化结构筛查在胎儿四肢畸形诊断中的应用

Application of ultrasound standardized structure screening in diagnosis of fetal limb deformity in 11～13^(+6) weeks of pregnancy

目的探讨孕11～13^(+6)周超声规范化结构筛查在胎儿四肢畸形诊断中的应用价值。方法 3132例孕妇作为研究对象,进行孕11～13^(+6)周超声规范化结构筛查,多切面检查胎儿肢体及手足,对诊断为四肢畸形的胎儿进行追踪随访,观察胎儿的超声图像特征。结果 3132例孕妇分娩3132例胎儿,超声规范化结构筛查确定为四肢畸形的胎儿共9例,占比0.287%,均予以引产,引产后经外观检查及尸检发现, 9例四肢畸形的超声规范化结构筛查结果与产后诊断结果相符。其中1例胎儿双下肢姿势固定合并骶尾部囊性暗区稍膨出,引产后诊断结果为脊柱裂;3例合并水肿胎,仅有1例染色体核型异常,为18-三体;其余5例染色体核型正常,引产后诊断结果相符。结论孕11～13^(+6)周超声规范化结构筛查在胎儿四肢畸形诊断中可发挥一定的应用价值,可及早发现胎儿畸形,进而采取有效的干预措施,有助于提升出生人口质量,值得推行。

Objective To discuss the application value of ultrasound standardized structure screening in diagnosis of fetal limb deformity in 11~13^+6 weeks of pregnancy.Methods A total of 3132 pregnant women were selected as the research subjects.The ultrasound standardized structure screening was performed to women at 11~13^+6 weeks of pregnancy.The limbs,hands and feet of fetuses were examined by multi-sectional examination.The fetuses diagnosed as limbs malformation were followed up and the ultrasonographic features of fetuses were observed.Results 3132 pregnant women gave birth to 3 132 fetuses.9 fetuses were identified as limb deformities by standardized ultrasound screening,accounting for 0.287%.All of them were induced labor.Appearance examination and autopsy showed that the results of standardized ultrasonographic screening for 9 cases of limb deformities were consistent with those of postpartum diagnosis.Among them,there were 1 case of fetal lower extremity posture fixation combined with sacrococcygeal cystic dark area slightly prolapse,and was diagnosed as spina bifida after induction of labor;3 cases complicated with edema fetus,only 1 case had abnormal chromosome karyotype,that was 18-trisomy;the other 5 cases had normal chromosome karyotype,and the diagnosis was consistent after induction of labor.Conclusion Ultrasound standardized structure screening at 11~13^+6 weeks of pregnancy can play a certain application value in the diagnosis of fetal limb deformities.It can detect fetal deformities as early as possible,and then take effective interventions to improve the quality of the birth population.So it is worth promoting.