产前多学科诊疗门诊在胎儿发育异常中的应用

Application of prenatal multi-disciplinary team clinics in fetal developmental abnormalities

目的 探讨产前多学科诊疗(multi-disciplinary team, MDT)门诊在胎儿发育异常中的应用情况。方法 采用回顾性分析方法,收集2021年12月—2022年11月在四川大学华西第二医院产科建档的孕妇中胎儿发育异常并完成产前MDT门诊诊疗的病例资料,对孕妇和胎儿的情况进行总结分析。结果 建档孕妇19362例,胎儿发育异常的孕妇1125例(5.8%),其中272例(24.2%)接受产前MDT门诊诊疗。胎儿发育异常以结构异常为主(208例,76.5%),排名前3的是中枢神经系统异常、循环系统异常及多发畸形。继续妊娠202例,引产70例,引产率25.7%。引产的主要原因前3位的是多发畸形、中枢神经系统异常和循环系统异常。经过产前MDT门诊诊疗,46例孕妇的胎儿发育异常诊断得以修正。结论 产前MDT门诊有助于胎儿发育异常病例的早期综合评估及诊疗方案的确定。

Objective To explore the application of multi-disciplinary team(MDT)clinics in fetal developmental abnormalities.Methods A retrospective analysis method was used to collect case data of fetal developmental abnormalities and completion of prenatal MDT clinics diagnosis and treatment in pregnant women who were registered in the Department of Obstetrics of West China Second Hospital,Sichuan University between December 2021 and November 2022.The situation of pregnant women and fetuses was summarized and analyzed.Results There were 19362 registered pregnant women,of which 1125(5.8%)had abnormal fetal development.Among them,272(24.2%)received prenatal MDT clinics diagnosis and treatment.Fetal developmental abnormalities were mainly characterized by structural abnormalities(208 cases,76.5%),with the top three being central nervous system abnormalities,circulatory system abnormalities,and multiple malformations.There were 202 pregnant women who continue to conceive,and 70 cases had undergone induced labor,with an induced labor rate of 25.7%.The top three main causes of induced abortion were multiple malformations,central nervous system abnormalities,and circulatory system abnormalities.After prenatal MDT clinics diagnosis and treatment,the diagnosis of fetal developmental abnormalities in 46 pregnant women were corrected.Conclusion Prenatal MDT clinics are helpful for the early comprehensive evaluation of fetal developmental abnormalities and the determination of diagnosis and treatment plans.