超声诊断胎儿出生缺陷漏误诊因素初步分析

Study on the Misdiagnosis and Missed Diagnosis of Fetal Birth Defect by Ultrasound

目的 探讨超声诊断胎儿出生缺陷 (胎儿先天畸形 )可能出现的漏误诊原因。方法 对 83例分娩证实的胎儿畸形与产前超声诊断结果进行回顾性对照分析。结果 超声诊断胎儿出生缺陷漏误诊率为 2 6 .5 %(2 2 / 83) ,各类出生缺陷漏误诊率依次为颜面部小器官缺陷 6 0 %(6 / 10 ) ,肢体缺陷 5 0 %(3/ 6 ) ,心脏缺陷 44 .4%(4/ 9) ,神经管缺陷17.2 %(5 / 2 9) ,淋巴管缺陷 16 .7%(1/ 6 ) ,腹腔脏器缺陷 15 .4%(2 / 13)。 1例胎儿指趾缺陷未检出 ;8例浆膜腔积液和l例胸腹联体无漏误诊。结论 超声诊断胎儿出生缺陷漏误诊与操作者技术经验、仪器条件、产前超声检查时间、次数及胎儿体位等因素有关。

Objective To study the possible cause in misdiagnosis and missed diagnosis of fetal birth defect(congenital fetal malformation)detected by ultrasound.Methods Eightythree cases of fetal malformations confirmed after labor were contrasted retrospectively with the ultrasound diagnosis before labor.Results The total rate missed diagnosis and misdiagnosis was 26.5 %(22/83),each rate different defect was as following: face 60 %(6/10),extremities 50 %(3/6),heart 44.4 %(4/9),neurocoele 7.2 %(5/29),lymphatic channel 16/7 %(1/6),abdominal visceral organs 15.4 %(2/13).One case of fingertoe defect was not detected,and 8 cases of effusion in the serum cavity and one thoraxabdomen conjunction malformation were definitely diagnosed.Conclusion The missed diagnosis and misdiagnosis rate of fetal defect are associated with the following factors:operator’s practical experience,capability of the instrument,prenatal examination phase and times,and fetal position.