孕11～13+6周行超声检查对胎儿前腹壁畸形的诊断价值分析

Diagnostic Value of Ultrasonography in Fetal Anterior Abdominal Wall Malformation at 11～13+6 Weeks of Pregnancy

目的研究分析超声检查在孕11~13+6周对胎儿前腹壁畸形的诊断应用价值。方法将2015年8月-2018年11月期间于焦作市第五人民医院接受孕早期胎儿结构筛查的孕妇共20000例定为研究对象,入院后均行规范化孕早期超声筛查。对超声检查结果中胎儿双顶径、股骨、肱骨长度、静脉导管血流频谱、颈项透明带厚度等常规筛查项目数据进行检测,并统计筛查结果,与妊娠结果进行对比。结果20000例孕妇中共检出前腹壁畸形胎儿共82(占总例数0.41%)例,其中腹裂者27例(占畸形儿32.93%),疑似腹裂者2例(占畸形儿2.44%),脐带膨出者35例(占畸形儿42.68%),疑似脐带膨出者9例(占畸形儿10.98%),生理性中肠疝者7例(占畸形儿8.53%)及体蒂异常者2例(占畸形儿2.44%)。82例畸形儿中79例妊娠结局与筛查结果相一致,占比96.34%,3例于孕中期检查排除畸形,占比3.66%。结论超声检查在孕11~13+6周胎儿结构筛查中,对于大部分存在前腹壁畸形的胎儿均具有较好的检出效果,但部分胎儿需通过孕中期结构筛查进一步确认筛查结果。

Objective To analyze the diagnostic value of ultrasound examination on fetal anterior abdominal wall malformation during 11 ~ 13 ^+6 weeks of pregnancy. Methods A total of 20,000 pregnant women who were screened for fetal structure in early pregnancy in Jiaozuo Fifth People's Hospital from August 2015 to November 2018 were selected as the study subjects, and standardized ultrasound screening in early pregnancy was performed after admission. The ultrasound examination results of fetal biparietal diameter, femur, humerus length, venous catheter blood flow spectrum, nuchal zona pellucida thickness and other conventional screening data were detected, and the screening results were statistically compared with pregnancy results. Results A total of 82 (0.41%) fetuses with anterior abdominal wall malformation were detected in 20,000 pregnant women, including 27 cases of abdominal fissure (32.93%), 2 cases of suspected abdominal fissure (2.44%), 35 cases of umbilical cord bulging (42.68%), 9 cases of suspected umbilical cord bulging (10.98%), 7 cases of physiological midgut hernia (8.53%) and 2 cases of abnormal pedicles (2.44%). Of the 82 deformed children, 79 cases had the same pregnancy outcome as the screening results, accounting for 96.34%, and 3 cases were excluded from malformation during the second trimester of pregnancy, accounting for 3.66%. Conclusion Ultrasonography has a good detection effect on most fetuses with anterior abdominal wall malformation in the structural screening of fetuses at 11 ~ 13 +6 weeks of gestation, but some fetuses need to further confirm the screening results through structural screening in the second trimester of gestation.