摘要
目的本研究通过超声对胎儿全面仔细产前Ⅲ级筛查,了解胎儿有无形态学上的畸形,同时对胎儿脐带结构和脐动脉血流进行详细检查、记录,了解其在胎儿畸形中的诊断价值及临床意义。方法本组病例收集2014年6月～2017年5月期间进行胎儿系统筛查发现有明确畸形60例作为畸形组;并同期收集80例正常胎儿作为对照组;其中孕妇平均孕龄(30±8.9)w,孕妇平均年龄(28.5±10.4)岁,并同时收集所有孕妇的相关临床资料,所有病例均遵循随机原则分组;对畸形组和正常组胎儿行Ⅲ级超声系统筛查及脐动脉血流频谱测定。结果 1,畸形组孕妇年龄明显高于对照组,差异性统计学意义(P<0.05)。2,畸形组中脐动脉血流频谱收缩期/舒张期比值(S/D)明显高于对照组(P<0.001),脐动脉舒张期血流频谱缺失(AEDF)或翻转(REDF)的胎儿发生畸形的机率较高(75%)。3,在所有胎儿中共有8例单脐动脉患者,其中4例合并胎儿畸形,在4例畸形胎儿中有1例S/D值增高,提示脐动脉血流频谱正常时,仍有可能发生胎儿畸形。在整个畸形组中,泌尿系统畸形,心血管系统畸形,多发系统畸形,皮肤及皮下组织疾病的S/D值异常明显高于对照组(P<0.05),中枢神经系统畸形,消化系统畸形,骨骼肌肉系统畸形与对照组相比差异无统计学意义(P>0.05)。结论 1,畸形组孕妇年龄偏大,提示孕妇年龄越大,发生胎儿畸形的慨率更高。2,S/D值增高在评价多系统畸形,皮肤及皮下组织疾病,泌尿系统和心血管系统畸形有较高的临床价值。在排除母体因素的情况下,脐动脉血流S/D值增高时,应进一步作胎儿系统超声检查(Ⅲ级筛查)排除胎儿畸形的可能。3,脐动脉血流频谱出现AEDF或REDF现象时,可能作为判断胎儿异常一个高风险指标,应作进一步的超声检查。4,单脐动脉的胎儿,不论有无脐动脉血流频谱的异常改变,其发生胎儿畸形的慨率都较大。
Objective： This study was carded out by ultrasound to complete prenatal screening of fetuses, To see if the fetus has any morphological deformities, The fetal cord structure and umbilical arterial blood flow were examined and recorded, To understand its diagnostic value and clinical significance in fetal malformation. Methods.. This group of case collection June 2014-May 2017 during the fetal system screening in our hospital found that there are definite deformities in 60 cases as a deformity group：80 normal fetuses were collected in the same period as control group： The average pregnant woman （30±8.9） week, the average age of pregnant women （28.5±10.4） , and the same time to collect all the relevant clinical data of pregnant women：All cases were grouped by random principles： screening of HI-level ultrasound system and determination of umbilical arterial blood flow spectrum in abnormal and normal groups of fetus. Results： 1, The pregnant women in the deformity group were significantly older than the control group, and the difference was statistically significant （P〈0.05） ; 2, The systolic/diastolic ratio （S/D） was significantly higher in the malformation group than in the control group （P〈0.001） , and the incidence of fetal malformation （AEDF） or Flip （REDF） was higher in the umbilical arterial diastolic blood flow spectrum （75%） .3, There were 8 cases of single umbilical artery in all fetuses, including 4 cases with fetal malformation, and in 4 cases of fetal malformation, 1 cases of s/ d value increased, which suggested that fetal malformation could still occur when the blood flow spectrum of umbilical artery was normal. In the whole deformity group, the urinary system deformity, the cardiovascular system deformity, the multiple system deformity, the skin and the subcutaneous tissue disease s/d value is obviously higher than the control group （P〈0.05） , the central nervous system deformity, the digestive system deformity, the skeletal muscle system deform
作者
李四清
颜媛
李蓉
LI Si-qing;YAH Yuan;LI Rong(Yibin the First lfospital,Depart Ulrasonic;Yibin,Jiangan Women and Children,Health Care Central Hospital)
出处
《中国优生与遗传杂志》
2018年第11期93-96,共4页
Chinese Journal of Birth Health & Heredity
关键词
脐动脉血流
S/D值
畸形
单脐动脉
AEDF
REDF
Umbilical artery blood stream
S/D valuc
Abnormal
Single umbilical artery
AEDF
REDF
