二维联合四维超声评估胎儿颜面部畸形的价值

Value of two-dimensional combined with four-dimensional ultrasound in evaluation of fetal facial malformation

目的探究二维联合四维超声评估胎儿颜面部畸形的价值。方法抽取2017年1月至2021年12月于漯河市第三人民医院进行常规产检的5012例孕妇为研究对象,所有孕妇均进行二维超声及四维超声检查,随访至孕妇分娩或引产,观察新生儿或引产胎儿颜面部畸形发生情况,并以新生儿或引产胎儿的最终检查结果为金标准,分析二维联合四维超声对胎儿颜面部畸形的评估价值。结果随访至孕妇分娩或引产,5012例孕妇中有45例出现新生儿或胎儿颜面部畸形,发生率为0.90%,其中唇腭裂发生最多,占总颜面部畸形的35.56%(16/45)。二维超声单独检查结果与新生儿或引产胎儿最终检查结果具有较为理想的一致性(0.40<Kappa<0.75),二维联合四维超声检查结果与新生儿或引产胎儿最终检查结果具有极好的一致性(Kappa>0.75)。二维联合四维超声评估胎儿颜面部畸形的准确度、灵敏度、特异度及阳性预测值均高于二维超声单独评估,差异有统计学意义(P<0.05),二维超声单独评估与二维联合四维超声评估胎儿颜面部畸形的阴性预测值比较,差异未见统计学意义(P>0.05)。结论二维联合四维超声对胎儿颜面部畸形的评估价值优于单独二维超声检查,可提高评估结果的准确度、灵敏度及特异度,减少漏诊、误诊情况的出现。

Objective To investigate the value of two-dimensional combined with four-dimensional ultrasound in the evaluation of fetal facial deformity.Methods A total of 5012 pregnant women who underwent routine prenatal examination in Luohe Third People’s Hospital from January 2017 to December 2021 were selected as the research subjects.All pregnant women underwent two-dimensional ultrasound and four-dimensional ultrasound.After follow-up to delivery or induction of labor of pregnant women,the incidence of facial deformities of newborns or induced labor fetuses were observed.With the final examination results of neonates or induced labor fetuses as the gold standard,the value of two-dimensional combined with four-dimensional ultrasound in evaluation of fetal facial malformations was analyzed.Results After follow-up to delivery or induction of labor,45 of 5012 pregnant women had neonatal or fetal facial deformity,with an incidence of 0.90%,in which cleft lip and palate occurred most,accounting for 35.56%(16/45)of the total facial deformity.The results of two-dimensional ultrasound alone had ideal consistency with the final examination results of newborns or induced labor fetuses(0.40<Kappa<0.75),and the results of two-dimensional combined four-dimensional ultrasound have excellent consistency with the final examination results of newborns or induced labor fetuses(Kappa>0.75).The accuracy,sensitivity,specificity and positive predictive value of two-dimensional combined with four-dimensional ultrasound in the evaluation of fetal facial deformity were higher than those of two-dimensional ultrasound alone,and the difference was statistically significant(P<0.05).There was no significant difference in the negative predictive value between two-dimensional ultrasound alone and two-dimensional combined four-dimensional ultrasound in the evaluation of fetal facial deformity(P>0.05).Conclusions The value of two-dimensional combined with four-dimensional ultrasound in the evaluation of fetal facial deformity is better than that of single two-dimensional ultrasound.The former can improve the accuracy,sensitivity and specificity of the evaluation results,and reduce the occurrence of missed diagnosis and misdiagnosis.