CDFI联合NT检查对胎儿先天性发育畸形的诊断价值

Diagnostic Value of CDFI Combined with NT Examination for Congenital Developmental Malformations in Fetuses

目的探讨彩色多普勒血流成像(CDFI)联合颈项透明层(NT)检查对胎儿先天性发育畸形的诊断价值。方法前瞻性分析,选取2019年6月至2022年9月于信阳市妇幼保健院产检的88例孕妇为研究对象,均接受NT和CDFI检查,并随访至孕妇引产或分娩。将妊娠结局及引产胎儿尸检核查结果作为胎儿先天性畸形诊断的金标准,分为发育正常组和发育异常组。比较两组胎儿NT检查中NT厚度及CDFI检查中肌动脉收缩期搏动指数(UAPI)与大脑中动脉搏指数(MCAPI)水平,绘制受试者工作特征(ROC)曲线,评估NT、UAPI与MCAPI单独及联合指标诊断胎儿先天性发育畸形的价值。结果引产胎儿尸检核查及正常分娩结果显示,88例胎儿中8例先天性发育畸形胎儿,占比9.09%,其中先天性心脏病4例,唐氏综合征1例,神经系统发育畸形2例,肾发育畸形1例;两组年龄、孕周、体重指数、是否首次妊娠比较差异无统计学意义(P>0.05);发育畸形组NT厚度、UAPI水平高于发育正常组,MCAPI水平低于发育正常组(P<0.05);绘制ROC曲线,结果显示,NT厚度、UAPI与MCAPI单独诊断妊娠妇女胎儿先天性发育畸形的曲线下面积(AUC)>0.7,具有一定的预测价值,联合预测的AUC为0.897,预测价值更高。结论CDFI联合NT检查对胎儿先天性发育畸形的诊断价值较高,有助于临床对胎儿先天性畸形尽早做出诊断。

Objective To explore the diagnostic value of color Doppler flow imaging(CDFI)combined with nuchal translucency(NT)for congenital developmental malformation in fetuses.Methods A prospective analysis was conducted in this study,and 88 pregnant women who underwent obstetric and gynecological examinations at Xinyang Maternal and Child Health Care Hospital from June 2019 to September 2022 were selected as the study subjects.All of them underwent NT and CDFI examinations.And follow-up to pregnant women induced labor or childbirth.The pregnancy outcome and the autopsy results of the induced fetus were seted as the gold standard for the diagnosis of fetal congenital developmental malformation,and they were divided into normal development group and abnormal development group,the NT thickness on NT examination and the levels of umbilical-artery pulsatility index(UAPI)and middle cerebral artery pulsation index(MCAPI)on CDFI examination were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to evaluate the value of NT,UAPI and MCAPI alone and combined diagnosis of fetal congenital developmental malformation.Results The results of autopsy and normal delivery showed that 8 of the 88 fetuses had congenital developmental abnormalities,accounting for 9.09%,including 4 cases of congenital heart disease,1 case of Down’s syndrome,2 cases of neurological developmental abnormalities,and 1 case of renal developmental abnormalities.There was no statistical difference between the two groups in age,gestational week,body mass index,and whether or not the first pregnancy occurred(P>0.05).The NT thickness and UAPI level in the abnormal development group were higher than those in the normal development group,while the MCAPI level was lower than that in the normal development group(P<0.05).The ROC curve was drawn,the results showed that the area under the curve(AUC)of NT thickness,UAPI and MCAPI alone diagnosis of fetal congenital developmental malformation in pregnant women was more than 0.7,which had certain predictive value,while the combined indicators predicted AUC was 0.897,with higher predictive value.Conclusion CDFI combined with NT examination has high diagnostic value for fetal congenital developmental malformation,which is helpful for early diagnosis of fetal congenital malformations.