孕早期规范化超声检查在胎儿畸形诊断中的应用分析

Analysis of the application of standardized ultrasound screening combined with four-dimensional imaging in diagnosis of fetal structural malformation in early pregnancy

目的探讨超声规范化结构筛查联合四维对孕11~13+6周胎儿畸形的临床价值。方法选取孕周在11~13+6周的7921例孕妇作为本次的研究对象,在显示胎儿正中矢状切面后对其进行颈项透明层厚度和静脉导管的精准测量,同时对胎儿的主要结构进行超声筛查,对有异常的胎儿结构进行四维成像。结果孕11~13+6周进行规范化超声筛查的7921例孕妇中发现胎儿结构异常共57例,检出率为0.72%(57/7921),漏诊2例,漏诊率为0.0025%(2/7921)。进行规范化超声筛查的孕妇中包括95例双胎和7826例单胎,所筛查出畸形中包括联体双胎1例,无脑儿4例,全前脑2例,丘脑融合1例,全身水肿及颈部水囊瘤27例,脊柱裂2例,四肢畸形3例,脐膨出6例,腹裂2例,巨膀胱4例,盆腔囊性包块1例,胎儿多系统畸形4例。漏诊的2例中,上述所检出畸形患儿均选择引产证实。结论孕11~13+6周进行规范化超声筛查联合四维可早期有效的筛查出胎儿结构畸形,对孕妇是否继续妊娠有指导作用。

Objective To explore the diagnostic value of standardized ultrasound combined with four-dimensional imaging for fetal structural malformation at 11~13+6 week pregnancy.Methods The birth test was carried out in Dezhou Maternal and Child Health Hospital,and 7921 pregnant women at 11~13+6 gestational weeks were selected as study subjects.After showing the median sagittal section of the fetus,the thickness of the transparent layer of the neck and venous catheter were accurately measured,and the main structure of the fetus was screened by ultrasound.Four-dimensional imaging of abnormal fetal structure was carried out.Results Of these 7921 pregnant women at 11~13+6 weeks who underwent standardized ultrasound screening,57 had abnormal fetal structures,with the detection rate of 0.72%(57/7921).Two cases were missed,with the missed diagnosis rate of 0.0025%(2/7921).The standardized ultrasound screening included 95 twins and 7826 single births.Among the abnormalities detected in this work,there were one case of conjoined twins,four cases of anencephalus,two cases of total forebrain,1 case of thalamus fusion,27 cases of systemic edema and neck hydrocystoma,2 cases of spina bifida,three cases of limb deformity,acromphalus of 6 cases,2 cases of abdominal fissure,4 cases of giant bladder,one case of pelvic cystic mass,and 4 cases of fetal multisystem malformation.Two cases were missed diagnosis.The above-mentioned abnormal children were confirmed by the induced labor.Conclusion The standardized ultrasound screening combined with four-dimensional imaging on pregnancy at 11~13+6 weeks can offer early and effective screening of fetal structural malformation,which has a guiding effect on determining whether the pregnancy continues or terminates at early period.