摘要
目的研究产前超声检查对胎儿畸形的诊断价值,分析漏诊原因及陕西地区胎儿畸形状况。方法回顾性分析西安交通大学医学院第一附属医院2011年1月至2013年10月间40 239例产前B超检查的报告。对20~28周的胎儿进行系统产前超声检查(Ⅲ级筛查),其他孕周的胎儿进行常规产前超声检查(Ⅱ级筛查)^([1])。结果 40 239例中,B超发现胎儿畸形845例,检出率为2.09%。845例畸形胎儿中,单发畸形668例,占79.05%,多系统畸形177例,占20.95%。845例畸形儿经出生后、引产、以及尸检或染色体检查证实,超声漏诊48例,漏诊率5.68%。所筛查出的畸形儿顺位及各自构成比依次为神经系统121例(14.31%)、心脏畸形110例(13.02%)、颜面部畸形86例(10.18%)、泌尿系统77例(9.11%)、消化系统60例(7.10%)、四肢骨骼系统52例(6.15%)、前腹壁畸形43例(5.09%)、呼吸系统34例(4.02%)、畸胎瘤26例(3.08%)、囊性淋巴管瘤19例(2.25%)、多系统畸形177例(20.95%)。结论陕西地区胎儿畸形发生率较高,且胎儿畸形种类繁多复杂。采用Ⅱ级、Ⅲ级筛查方法进行规范化的检查,胎儿畸形的检出率高。
Objective To explore the diagnostic value of prenatal ultrasonography to fetal malformation and to analyze the reasons of missed diagnosis and the situation of fetal malformation in Shaanxi Province. Methods Retrospective analysis was conducted on the prenatal ultrasound examination report of 40 239 cases from January 2011 to October 2013 in the First Affiliated Hospital of Xi＇ an Jiaotong University. Obstetric ultrasonic examination （ Level Ⅲ ） was specifically applied on gestations between 20-28 weeks, and routine obstetric ultrasonic examination （ Level Ⅱ ） was performed for the other gestations. Results Among 40 239 cases, 845 cases were found with fetal malformations, and the detection rate was 2.09%. Of the cases with fetal malformation, 668 cases suffered single abnormality （79.05%） and 177 cases suffered multiple malformations （20.95%）. There were 845 cases confirmed by induced labor, autopsy, after birth confirmation or chromosome examination. Forty-eight cases missed diagnosis （5. 68% ）. The sequence and constituent ratio of fetal malformations were as followed： nervous system malformations （ 13. 02% ）, cardiac malformations （ 14. 3% ）, facial malformations （10.18%）, urinary system malformations （9. 11%）, digestive system malformations （7. 1%）, appendicular skeleton system malformations （6. 15% ）, anterior abdominal wall malformations （5. 09% ）, respiratory system malformations （4.02%）, teratoma （3.08%）, cystic lymphangioma （2. 25% ）, and multi-system malformations （20. 95% ）. Conclusion The incidence of fetal malformations in Shaanxi Province is higher than other provinces, with a wider range and more complicated fetal malformations. The detection rate of fetal malformation is high when Level II and Level III screening methods are routinely carried out.
出处
《中国妇幼健康研究》
2014年第1期72-74,共3页
Chinese Journal of Woman and Child Health Research
关键词
胎儿畸形
产前检查
超声诊断
回顾分析
fetal malformation
prenatal uhrasonography
ultrasound diagnosis
retrospective analysis
