摘要
目的探讨胎儿肠管扩张产前超声异常表现及妊娠结局相关性。方法对2009年7月至2013年6月在南京医科大学附属苏州医院苏州市立医院产前超声检出肠管扩张的118例胎儿超声声像图表现及妊娠结局进行总结分析。结果 118例胎儿产前超声表现及妊娠结局:(1)小肠扩张101例:98例肠管轻度扩张,最宽内径为7.2～22.6 mm,31例合并唇腭裂、羊水过多、肠管强回声等其他异常超声表现。1例唇腭裂胎儿于妊娠25周引产,97例妊娠结局良好;3例肠管明显扩张,超声动态观察肠管进行性增宽,最宽内径均超过30.0 mm,伴羊水持续增多,妊娠34周宫内死亡2例,1例出生后1周因肠梗阻死亡。(2)结肠扩张17例,16例34周后发现结肠扩张,最宽内径均小于30.0 mm,伴羊水过多或减少,胎儿肠管强回声等软指标异常,妊娠结局良好;1例中孕期发现羊水过多及胎儿下腹部"双叶征"团块,产后证实为肛门闭锁。结论肠管扩张胎儿多数在超声随访过程证实为一过性肠管扩张,妊娠结局转归良好;但肠管扩张动态观察过程中小肠内径持续增宽,扩张程度加重、羊水量持续增多,胎儿妊娠结局不良;如检出胎儿肠管强回声,发生肠梗阻的可能性较低;超声检查怀疑结肠梗阻及肛门闭锁的胎儿,观察肠道形态变化更有意义。
Objective To explore the ultrasonographic features of fetal gaslrointestinal tract dilatation and associated abnormalities. Methods From July 2009 to June 2013, 118 cases of fetal bowel dilatation of detected by prenatal ultrasound in our hospital were followed up for their ultrasonographic changes and pregnancy outcomes. The features of fetal bowel dilatation with associated abnormalities and their impact on pregnancy outcomes were summarized. Results Among the 118 cases of fetuses, 101 cases had small bowel dilatation, including 4 cases with adverse pregnancy outcomes. One case had cleft lip and palate and was aborted during 25% week of pregnancy. The other 3 cases had continuous excess of amniotic fluid and progressive widening of bowel, the average inner diameter of which was above 30.0 mm. In the 3 cases, 2 cases ended with mlranterine death during 34 week of pregnancy and 1 case ended with death at one week after birth. Among the 97 cases of pregnant women with good pregnancy outcomes, 66 cases （66/97） were solitary bowel dilatation, while the remaining 31 cases （31/97） were associated with abnormal soft markers, e.g., excess or decrease of amniotic fluid, fetal echogenic bowel, fetal uronephrosis, short femur, single umbilical artery, fetal widened lateral ventricles and placenta overripe, etc. Among the 17 cases of colonic dilatation, 1 case had exessive amniotic fluid and ＂double- leaf sign＂ clumps in abdomen during the second trimester and was proved to be anal atresia post partom, while the remaining 16 eases had the colonic dilatation which were found after 346 week of pregnancy and the widest inner diameter of colon was less than 30.0 mm associated with abnormal soft markers like excess or decrease of amniotic fluid and fetal echogenic bowel, etc., and associated with good pregnancy outcomes. Conclusions Most fetuses with mild to moderate bowel dilatation had favorable outcomes. During ultrasonic examination, the degree and dynamic change of bowel dilatation shall be observed. If bowel di
出处
《中华医学超声杂志（电子版）》
2014年第7期46-49,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
超声检查
产前
胎儿
肠梗阻
Ultrasonograph, prenatal
Fetal
Haemodynamics
Intestinal obstruction
