孕期超声与甲状腺功能减低对胎儿股骨短小的诊断价值

The diagnostic value of ultrasonography and thyroid function in pregnancy for fetal short femur

目的探讨孕期超声联合孕妇甲状腺功能减低对胎儿股骨短小的诊断价值。方法回顾性分析2017年~2019年在江苏省人民医院产检且孕期胎儿股骨短小的49例孕妇作为观察组,以孕期胎儿股骨与孕周相符合的46例孕妇作为对照组,检测两组胎儿超声测值及孕妇甲状腺功能,对两组数据进行分析。结果观察组游离四碘甲腺原氨酸(FT4)较对照组明显降低(P<0.05);低T4血症与亚临床甲减的孕妇发生胎儿股骨短小的人数较甲功正常的明显增多(P<0.008);孕31~37周不同甲状腺功能状态下出现胎儿股骨短小的差异性有统计学意义(P<0.05)。结论胎儿股骨短小与母体低T4血症及亚临床甲减有关,甲减对胎儿股骨短小的影响与孕周有关,孕期超声联合孕妇甲状腺功能检测对诊断胎儿股骨短小有重要的临床价值。

Objective To investigate the relationship between fetal short femur and thyroid hormone deficiency in late pregnancy.Methods We retrospectively analysed pregnant women with completed data in normal labor examination in Maternal and Child Health Care Hospital of Jiangsu Province,and selected 49 pregnant women with short femur during pregnancy as observation group.46 pregnant women with fetal femur was consistent with the corresponding gestational age as control group.We collected and compared the fetal ultrasound data and the thyroid function of pregnant women between the observation group and the normal control group.Results In the observation group,free tetraiodothyronine(FT4)was significantly lower than that in the control group(P<0.05).Compared with pregnant women of normal thyroid function,the number of the fetal short femur in pregnant women with hypothyroxinemia and subclinical hypothyroidism were obviously increased(P<0.008).There were significant differences in fetal femur short in different thyroid function states between 31 and 37 weeks of gestation(P<0.05).ConclusionFetal short femur mostly occurs in late pregnancy,which is related to hypothyroxinemia and subclinical hypothyroidism.The influence of thyroid disease on fetal femur is related to gestational age.Ultrasound combined with thyroid function in late pregnancy has important clinical value in the diagnosis of fetal short femur.