胎儿不同程度足内翻的产前超声表现及妊娠结局分析

Prenatal Ultrasonography and Pregnancy Outcome Analysis of Different Degrees of Fetal Varus

目的:观察胎儿不同程度足内翻的产前超声表现,探讨并分析其不同的妊娠结局。方法:对45例在江门市中心医院产前超声诊断为足内翻的胎儿足部进行二维超声扫查及三维超声成像,根据胎儿足部内翻程度进行评分,并对合并的结构异常进行归纳总结。追踪至产后或引产后,对不同妊娠结局进行分析。结果:45例超声诊断为足内翻病例中,0.5~1.0分有3例,产后均证实为假阳性病例;1.5~2.0分有13例,产后均证实为单纯足内翻;2.5~3.0分有15例,其中10例产后证实为单纯足内翻,5例合并不同程度的其他结构异常;3.5~4.0分有14例,均合并不同程度的其他结构异常。较常见的合并畸形类型有心血管畸形、肢体畸形、腹部结构异常及神经系统畸形,其中心血管畸形发生率最高。结论:产前对胎儿足内翻的超声评分与妊娠结局高度相关。通过对足内翻程度的量化评估及合并畸形的超声诊断,为产前诊断提供依据,并评估胎儿预后。

Objective:To observe the prenatal ultrasound manifestations of fetuses with different degrees of clubfoot,and to explore and analyze the different pregnancy outcomes.Methods:Two-dimensional ultrasound scanning and three-dimensional ultrasound imaging were performed on the feet of 45 fetuses with prenatal ultrasound diagnosis of clubfoot in the hospital,and the fetuses were scored according to the degree of clubfoot,and the combined structural abnormalities were summarized.Follow-up to postpartum or after induction of labor,different pregnancy outcomes were analyzed.Results:Of the 45 cases diagnosed as clubfoot by ultrasound,there were 3 cases with a score of 0.5 to 1,all of which were confirmed as false-positive cases after delivery.There were 13 cases with 1.5 to 2 points,and all were confirmed to have simple clubfoot after delivery.There were 15 cases with scores of 2.5 to 3,of which 10 cases were postnatally confirmed as simple clubfoot and 5 cases combined with other structural abnormalities of varying degrees.There were 14 cases with scores of 3.5 to 4,all combined with other structural abnormalities of varying degrees.The more common types of combined malformations are cardiovascular malformations,limb malformations,abdominal structural anomalies and neurological malformations,with the highest incidence of cardiovascular malformations.Conclusion:Prenatal ultrasound scoring of fetal clubfoot is highly correlated with pregnancy outcome.The quantitative assessment of the degree of clubfoot and the ultrasound diagnosis of combined malformations provide a basis for prenatal diagnosis and assessment of fetal prognosis.