系统超声检查在不同孕期诊断胎儿畸形的临床观察

Clinical observation of systematic ultrasound examination for diagnosis of fetal malformation in different stages of pregnancy

目的阐述系统超声检查用于诊断胎儿畸形的具体方法及效果,并分析孕期与胎儿畸形筛查准确性的关系。方法该次研究时间为期2年,2017年6月至2019年6月,研究对象选择于该院接受产前胎儿畸形检查的孕妇200例,分别于孕早期、孕中期及孕晚期进行系统超声检查,以产后或尸检结果为标准计算系统超声检查的准确率,同时分析不同孕期检出胎儿畸形的概率。结果 200例孕妇经系统超声总计检出畸形胎儿47例,而产后或尸检共计畸形胎儿49例,漏诊2例,系统超声诊断准确率为95.92%,其中孕中期检出胎儿畸形概率明显高于孕早期、孕晚期检出率(P<0.05)。分析发现,孕早期检出胎儿畸形情况主要以胸腔壁畸形、中枢神经畸形为主,孕中期则以心血管、面部、颈部畸形为主,孕晚期以泌尿系统畸形、肿瘤等为主。结论利用系统超声技术筛查胎儿畸形准确性较高,孕中期胎儿畸形检出率最高,不同孕期筛查比较能够有效提高畸形检出率,提倡应用。

【Objective】To explain the specific methods and effects of systemic ultrasound examination for diagnosis of fetal malformation, and to analyze the relationship between pregnancy and accuracy of fetal malformation screening.【Methods】The study period lasted for 2 years. From June 2017 to June 2019, 200 pregnant women who received prenatal fetal malformation examination in our hospital were selected as the study subjects, which were performed systemic ultrasound examination in early pregnancy, the second trimester and third trimester, the accuracy of systematic ultrasound examination was calculated based on the postpartum or autopsy results, and the probability of detecting fetal malformation during different stages of pregnancy was analyzed.【Results】A total of 47 cases of malformed fetuses were detected by systemic ultrasound in 200 cases of pregnant women, and 49 cases of malformed fetuses were postpartum or autopsy, and 2 cases were missed. The accuracy of systemic ultrasound diagnosis was 95.92%. The detection rate of fetal malformation in the second trimester was significantly higher than that in the first trimester and the third trimester(P<0.05). The analysis found that the fetal malformation detected in the first trimester was mainly caused by thoracic wall malformation and central nervous system malformation. In the second trimester, cardiovascular, facial and neck deformities were dominant, and urinary system malformations and tumors were mainly in the third trimester.【Conclusion】The use of systemic ultrasound technology to screen fetal malformation is highly accurate, and the detection rate of fetal malformation is the highest in the second trimester. Screening in different pregnancy periods can effectively improve the detection rate of deformity and promote its application.