11~13^(+6)周胎儿犁腭部测值及其对唇腭裂的诊断价值

Evaluation of measuring vomer-palate diameters at 11-13^(+6)weeks of gestation and its diagnostic value for cleft lip and palate

目的探讨孕11~13^(+6)周胎儿犁腭部长径和厚径的参考值范围及其对该孕期胎儿唇腭裂的诊断价值。方法选取2020年5月至2021年8月于广东省妇幼保健院行孕11~13^(+6)周超声检查的孕妇1559例,在头面部正中矢状面观察胎儿犁腭部,分别测量其长径和厚径,制定正常胎儿参考值范围。将在此期间诊断并随访证实的唇腭裂胎儿犁腭部长径和厚径与参考值范围作比较,验证该参考值范围对孕11~13^(+6)周胎儿唇腭裂的诊断价值。结果按照不同孕周将1518例正常胎儿分别分为11~11+6周、12~12^(+6)周、13~13^(+6)周,胎儿犁腭部长径参考值分别为4.3~5.9 mm、5.0~6.8 mm、5.4~7.7 mm,厚径参考值分别为2.0~2.9 mm、2.2~3.4 mm、2.5~3.8 mm。胎儿犁腭部长径和厚径与胎儿头臀长呈显著正相关(r_(s)=0.733、0.634,均P<0.001)。1559例胎儿中,25例诊断并证实为唇腭裂,其犁腭部厚径均小于参考范围最小值,22例(88.0%)胎儿的犁腭部长径小于参考值。结论孕11~13^(+6)周胎儿犁腭部长径和厚径参考值范围的建立对该时期胎儿唇腭裂的筛查具有一定价值,可作为评价孕早期胎儿犁腭部发育的观测指标之一。

Objective To investigate the reference range of the length and thickness of the fetal vomer-palate diameters at 11-13^(+6) weeks,and their role in the diagnosis of cleft lip and palate(CLP).Methods From May 2020 to August 2021,1559 pregnant women who underwent ultrasound examination at 11-13^(+6) weeks in Guangdong Women and Children Hospital were selected,and the fetal vomer-palate in the median sagittal plane of the face was observed.The length and thickness diameters of the fetal were measured separately to establish the reference value range of normal fetal.The reference range was compared with the vomer-palate data of fetuses with confirmed CLP.Results The 1518 normal fetuses were divided into 11-13^(+6) weeks,12-12^(+6) weeks and 13-13^(+6) weeks.The reference values of the long diameter of fetal vomer-palatine were 4.3-5.9 mm,5.0-6.8 mm,5.4-7.7 mm,and the reference values of the thick diameter were 2.0-2.9 mm,2.2-3.4 mm,and 2.5-3.8 mm,respectively.The length and thickness of the fetal vomer-palatine were significantly positively correlated with the Crown-rump length(rs=0.733,0.634;all P<0.001).In the 1559 fetals,25 cases were diagnosed and confirmed with CLP,and the vomer-palate thickness diameters were smaller than the reference values in all cases,meanwhile,the vomer-palate length diameters of 22(88.0)%cases were smaller than the reference values.Conclusions The reference range of fetal vomer-palate length and thickness at 11-13^(+6) weeks of gestation is valuable for the screening of fetal CLP.