孕中期超声表现异常的相关性分析

Correlation analysis of abnormal ultrasound manifestations in second trimester of pregnancy

目的:对孕中期超声异常表现进行分析,探讨相关特征。方法:收集近5年经桂林医学院附属医院羊膜穿刺术诊断为非整倍体染色体异常的胎儿共145例,对胎儿在孕19~24周超声检查结果进行回顾性分析。结果:145例非整倍体染色体异常胎儿中,最常见的超声改变是心脏异常31例(21.4%)、鼻骨缺失29例(20.0%)、四肢畸形13例(9.0%)和大脑异常10例(6.9%);81例唐氏综合征中,孤立性软指标26例,占32.1%,超声结果阴性占50.6%;心脏畸形和四肢畸形是18三体综合征最常见的超声结构异常(73.9%,21.7%);大多数鼻骨异常的软指标出现在唐氏综合征(89.6%);脑畸形与18三体综合征(21.7%)和13三体综合征(71.4%)关系密切,但与唐氏综合征和特纳综合征无关系。结论:孕19~24周超声检查结果提示结构异常或存在超声软指标的情况在每种非整倍体染色体异常中都有特征性分布,需要对阳性率高的指标加以警惕,并加强孕期监测及护理的宣教。

Objective:To analyze the abnormal ultrasonic manifestations in the second trimester of pregnancy,and to explore the relevant characteristics.Methods:145 fetuses with aneuploidy chromosome abnormalities diagnosed by amniocentesis in the Affiliated Hospital of Guilin Medical University in the past five years were collected.The results of ultrasonography at 19~24 weeks of gestation were analyzed retrospectively.Results:Among 145 cases of aneuploid chromosome abnormalities,the most common ultrasound abnormalities were cardiac abnormalities(31 cases,21.4%),absent nasal bone(29 cases,20.0%),extremity deformities(13 cases,9.0%)and Cerebral abnormalities(10 cases,6.9%),among 81 cases of Down syndrome,26 cases had isolated soft markers(32.1%),and 50.6%were negative in ultrasound.Cardiac and limb malformations were the most common structural abnormalities in Trisomy 18(73.9%,21.7%),most nasal bone abnormalities occur in Down’s syndrome(89.6%),brain malformations are closely related to Trisomy 18(21.7%)and Trisomy 13(71.4%),but had no association with Down’s syndrome and Turner’s syndrome.Conclusion:Ultrasound findings at 19~24 weeks of gestation with structural abnormalities or the presence of soft ultrasound markers have characteristic distribution in each aneuploid chromosome abnormality.It is necessary to be vigilant for the indicators with high positive rate,and strengthen the education of monitoring and nursing in pregnancy.