摘要
目的探讨早孕期（孕11～13^＋6周）胎儿规范化超声检查的意义。方法回顾性分析2010年1月至2012年12月在首都医科大学附属北京妇产医院行早孕期超声检查的29858例胎儿的超声检查资料，对存在结构异常、颈项透明层（NT）增厚的病例进行随访。结果29858例胎儿中，早孕期超声检查发现284例胎儿存在结构异常，占0．95％，共检测到328个结构异常，包括胎儿水肿（124例）、脉络丛囊肿（36例）、露脑畸形（32例）、腹裂（24例）、脐膨出（22例）、心脏异常（19例）、巨膀胱（14例）、脊柱排列异常（10例）、脑膜脑膨出（9例）、全前脑（8例）、脑积水（7例）、肢体异常（7例）、无脑儿（6例）、羊膜带综合征（4例）、腹腔囊肿（3例）、联体双胎／寄生胎（3例）；全部露脑畸形、腹裂、脐膨出、脑膜脑膨出、全前脑、肢体异常、无脑儿、羊膜带综合征、联体双胎／寄生胎等表面结构异常选择终止妊娠并通过引产后大体标本所见得到证实；继续妊娠的4例巨膀胱胎儿中，2例中、晚孕期超声随访未见异常，1例证实合并染色体异常，1例中、晚孕期超声检查发现合并多发畸形；36例脉络丛囊肿胎儿中，除1例合并染色体异常外，余35例中、晚孕期超声检查未见异常；继续妊娠的21例水肿胎儿中，13例合并染色体异常，4例中、晚孕期超声检查发现合并其他结构异常。早孕期超声检查发现422例胎儿NT增厚，占1．41％，其中122例合并结构异常和（或）水肿，占28．91％；422例NT增厚的胎儿中，99例进行染色体检查，其中38例存在染色体异常；继续妊娠的298例胎儿中，21例在中、晚孕期超声检查中发现结构异常，分别为心脏结构异常（14例）、神经系统异常（4例）及膈疝（3例）。结论早孕期规范化超声检查可对胎儿结构畸形及染色体异常的筛查提供帮助。
Objective To evaluate the significance of standardized ultrasound examination of fetal structures in the first trimester （11-13＋6 weeks）. Methods The ultrasound data of 29 858 fetuses who underwent the first trimester screening were analyzed retrospectively in Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2010 to December 2012 and followed up the cases with structural abnormalities and increased nuchal translucency （NT）. Results Among 29 858 fetuses, 328 structural defects were detected in 284 fetuses （0.95%） by ultrasound in the first trimester, including fetal hydrops （124 cases）, choroid plexus cysts （36 cases）, exencephaly （32 cases）, gastroschisis （24 cases）, exomphalos （22 cases）, cardiac defects （19 cases）, megacystis （14 cases）, spine abnormalities （10 cases）, meningoceles/encephaloceles （9 cases）, alobar holoprosencephaly （8 cases）, hydrocephaly （7 cases）, abnormalities of extremities （7 cases）, acrania （6 cases）, amniotic band syndrome （4 cases）, abdominal cyst （3 cases） and conjoined twins （3 cases）. Pregnancy was terminated in all cases （115） with exencephaly, gastroschisis, exomphalos, meningoceles/encephaloceles, alobar holoprosencephaly, hydrocephaly,abnormalities of extremities, acrania, amniotic band syndrome and conjoined twins, and the defects were verified by the gross appearance of fetuses. Two cases of megacystis were turned out to be normal during follow-up while 1 case was proved to be aneuploid and 1 other case progressed to multiple abnormalities during the second trimester. Most choroid plexus cysts, except 1 case of aneuploid, were normal during the second and the third trimester follow-ups by ultrasound. Thirteen cases of fetal hydrops were found to be aneuploids and 4 hydrops cases were proved to be complicated with other structural defects during the second and the third trimester. NT was increased in 422 cases （1.41%）, among which 122 cases （28.91%） were
出处
《中华医学超声杂志（电子版）》
2013年第11期59-63,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
国家科技支撑计划(2006BAI05A04)
北京市科学技术委员会首都特色临床医学项目基金(D101100050010039)
关键词
超声检查
产前
早孕期
结构异常
颈项透明层
Ultrasonography, prenatal
First trimester
Structural abnormality
Nuchaltranslucency
