产前超声在单脐动脉及合并胎儿畸形中的诊断价值

Diagnostic value of prenatal ultrasound in single umbilical artery combined with fetal malformation

目的研究产前超声在单脐动脉及合并胎儿畸形中的诊断价值。方法纳入单脐动脉病例113例,根据是否合并胎儿畸形将其分为对照组(67例,单纯性单脐动脉)和观察组(46例,单脐动脉合并胎儿畸形)。统计观察组胎儿的畸形类型分布、两组胎儿的染色体异常情况及围产资料。结果观察组胎儿中,以心血管系统、肢体和泌尿系统畸形为主要的畸形类型。观察组染色体异常11例(23.91%),8例18-三体,1例13-三体,2例染色体结构异常;观察组的染色体异常率显著高于对照组(P<0.05)。两组的妊娠结局、早产率、胎龄、新生儿体质量比较,差异具有统计学意义(P<0.05)。结论产前超声有助于提高单脐动脉胎儿的临床诊断率,对于单脐动脉合并胎儿畸形,建议进一步开展染色体检查。单纯性单脐动脉胎儿大多妊娠结局较好,然而单脐动脉合并畸形胎儿的早产、低出生体重发生率有所增加,应加强孕期监测。

Objective To study the diagnostic value of prenatal ultrasound in single umbilical artery combined with fetal malformation.Methods A total of 113 cases of single umbilical artery were included and divided into control group(67 cases,simple single umbilical artery)and observation group(46 cases,single umbilical artery combined with fetal malformation)according to whether there were complicated with fetal malformation.The distribution of fetal malformation types of the observation group,chromosomal abnormalities and perinatal data of fetuses of the two groups were statistically analyzed.Results Among the fetuses in the observation group,cardiovascular system,limb and urinary system malformations were the main malformations.There were 11 cases(23.91%)of chromosomal abnormalities in the observation group,8 cases were trisomy 18,1 case was trisomy 13,and 2 cases were abnormal in chromosome structure;the abnormal rate of chromosomes in the observation group was significantly higher than that in the control group(P<0.05).There were significant differences in pregnancy outcome,premature delivery rate,gestational age and neonatal weight between the two groups(P<0.05).Conclusion Prenatal ultrasound helps to improve the clinical diagnosis rate of fetuses with a single umbilical artery.For single umbilical artery combined with fetal malformations,it is recommended to carry out further chromosomal examinations.Most fetuses with simple single umbilical artery have good pregnancy outcomes,however,the incidence of premature delivery and low birth weight of single umbilical artery with fetal malformation has increased,and pregnancy monitoring should be strengthened.