连续顺序追踪超声法联合彩色多普勒超声产前诊断胎儿肢体畸形的价值

Value of systematic continuous sequence approach ultrasound combined with color Doppler ultrasound in prenatal diagnosis of fetal limb deformitiess

目的分析连续顺序追踪超声法联合彩色多普勒超声诊断产前胎儿肢体畸形的价值。方法回顾性分析2020年1月至2022年12月河南省妇幼保健院收治的106例产前高度疑似胎儿肢体畸形产妇的资料。查阅产妇档案、医院HIS系统及影像学检查资料,胎儿出生或引产后确诊为胎儿肢体畸形12例,无胎儿肢体畸形94例。分析连续顺序追踪超声法、彩色多普勒超声检查产前诊断胎儿肢体畸形的价值。结果106例产妇孕前彩色多普勒超声检查,检出胎儿肢体畸形7例(6.60%,7/106);彩色多普勒超声检查结果与胎儿出生或引产后检查结果的一致性一般(Kappa=0.60,P<0.001)。106例孕妇产前经连续顺序追踪超声法联合彩色多普勒超声检查,检出胎儿肢体畸形11例(10.38%,11/106);连续顺序追踪超声法联合彩色多普勒超声检查与胎儿出生或引产后检查结果的一致性较好(Kappa=0.756,P<0.001)。连续顺序追踪超声法联合彩色多普勒超声检查的准确度显著高于彩色多普勒超声检查(P<0.05),两种检查方式的诊断灵敏度、特异度、阳性预测值、阴性预测值比较差异未见统计学意义(P>0.05)。结论连续顺序追踪超声法联合彩色多普勒超声产前诊断胎儿肢体畸形的结果与胎儿出生或引产后检查结果一致性较好,可为产前诊断胎儿肢体畸形提供参考。

Objective To analyze the value of systematic continuous sequence approach ultrasound combined with color Doppler ultrasound in prenatal diagnosis of fetal limb deformities.Methods A retrospective analysis was conducted on the data of 106 expectant mothers with highly suspected fetal limb deformities treated in Maternal and Child Health Hospital of Henan Province from January 2020 to December 2022.The maternal records,hospital HIS system and imaging examination data were consulted.According to the examination results after birth or induction of labor,12 cases had fetal limb malformations,while 94 cases had no fetal limb malformations.The value of prenatal systematic continuous sequence approach ultrasound and color Doppler ultrasound in diagnosing prenatal fetal limb deformities were analyzed.Results Among the 106 pregnant women,7 cases(6.60%,7/106)had fetal limb deformities detected by color Doppler ultrasound before pregnancy.The consistency between the results of color Doppler ultrasound examination and the examination results after birth or induced abortion was average(Kappa=0.60,P<0.001).And 11 of 106 pregnant women(10.38%,11/106)had fetal limb deformities according to prenatal systematic continuous sequence approach ultrasound combined with color Doppler ultrasound examination.The combination of systematic continuous sequence approach ultrasound and color Doppler ultrasound showed good consistency with the examination results after birth or induced abortion(Kappa=0.756,P<0.001).The accuracy of systematic continuous sequence approach ultrasound combined with color Doppler ultrasound was significantly higher than that of color Doppler ultrasound,and the difference was statistically significant(P<0.05).There was no significant difference in sensitivity,specificity,positive predictive value,and negative predictive value between the two examination methods(P>0.05).Conclusions Systematic continuous sequence approach ultrasound combined with color Doppler ultrasound has better consistency with the examination after birth or induced labor.It can provide a reference for prenatal diagnosis of fetal limb deformities.