系统胎儿超声检查在先天畸形诊断中的应用研究

目的 探讨系统胎儿超声检查诊断胎儿畸形的价值.方法 对47 109例孕12～42周的孕妇进行产前超声检查,其中23 901例孕妇开展常规超声检查,23 208例孕妇开展系统胎儿超声检查.对比两种超声检查的畸形检出率,评估系统胎儿超声检查的价值.结果 与常规超声检查比较,系统胎儿超声检查的畸形检出率、心脏畸形检出率、颜面部畸形检出率均提高,≥28孕周畸形胎儿引产率下降,差异均有统计学意义（P＜0.05）.结论 系统胎儿超声检查与常规超声检查比较,畸形检出率高,诊断孕周提前,此方法在产前诊断中起着重要的作用.     

Ⅲ级系统胎儿产前超声筛查对胎儿畸形的诊断价值

目的探讨Ⅲ级系统胎儿产前超声筛查对胎儿畸形的诊断价值。方法选取2009年1～12月间进行产前检查的1 825例孕22～28周的孕妇,采用Ⅲ级系统胎儿产前超声检查,对胎儿畸形进行筛查和诊断。结果 1825例孕妇中,经引产或出生后证实的各种畸形63例,超声产前检出60例,漏诊3例,漏诊病例主要表现为较小畸形和缺陷。结论Ⅲ级系统胎儿产前超声检查是显示胎儿形态结构及产前诊断胎儿畸形的重要影像方法。     

崇明地区产前系统超声筛查胎儿畸形8130例临床分析

目的探讨基层医院开展产前系统超声筛查胎儿畸形的临床价值。方法8 130例胎儿接受常规产前超声检查(Ⅱ级)结合系统产前超声检查(Ⅲ级)资料进行回顾性分析,以产后最终诊断为标准。结果超声诊断胎儿畸形共83例,其中,单发畸形74例,多发畸形9例,胎儿畸形检出率1.02%,诊断符合率90.22%;漏诊9例,漏诊率9.78%。结论加强基层医院规范化产前系统超声筛查技术培训与应用,有助于及时检出胎儿畸形,降低先天畸形胎儿出生率。     

产前超声诊断胎儿畸形的临床价值

目的:探讨产前超声诊断胎儿畸形的临床价值。方法:选取我科2011年1月²013年6月收治的5 200例孕妇进行产前超声诊断,对其中诊断发现后经分娩或引产证实的98例胎儿畸形的临床资料进行回顾性分析。结果:5 200例接受产前超声检查的孕妇中,98例经分娩或引产证实为胎儿畸形,产前超声检查诊断出93例,检出率为94.9%(93/98),漏诊5例,漏诊率为5.1%(5/98)。结论:产前超声检查方便、无痛、无创、无辐射,且具有可重复性,对胎儿畸形产前诊断有重要的临床价值。     

产前系统超声检查诊断胎儿畸形的价值

目的 探讨胎儿畸形的声像图改变及产前系统超声筛查的价值.方法 回顾性分析19 884例产前系统超声检查资料,并与分娩或引产结果进行对比.结果 检出胎儿畸形180例,检出率为9.05‰.漏诊8例,漏诊率0.4‰.结论 产前系统超声是产前诊断胎儿畸形的主要方法,对提高出生人口素质具有重要意义.     

动态三维超声诊断胎儿肢体畸形的临床价值

目的 探讨动态三维超声在产前诊断胎儿肢体畸形中的临床应用价值.方法 对862例孕妇进行胎儿肢体二维超声常规检查,对二维超声检查怀疑有肢体畸形的病例进行动态三维超声检查,并与引产或生产结果对照.结果 862例孕妇中有21例孕妇有生产或引产结果对照.21例胎儿肢体畸形的孕妇产前超声诊断19例肢体畸形共12种32处,诊断不全1例(2处),漏诊1例,产前动态三维超声诊断的准确率为90.5%;二维超声诊断的准确率为61.9%,二者比较差异有统计学意义(P＜0.05).结论 动态三维超声可明显提高胎儿肢体畸形产前诊断的敏感性及准确度.具有较高的诊断价值.     

产前超声诊断胎儿畸形165例（附8例报告）

目的探讨超声检查在产前筛查胎儿畸形中的临床应用价值。方法应用二维及彩色多普勒超声对4182例孕妇行产前常规检查。结果胎儿畸形发生率3．94％，多数经引产、手术或追踪随访证实。先天性心脏病近期诊断率在不断提高。结论先天畸形儿的产前诊断率呈上升趋势，超声检查是产前诊断的主要方法，畸形检出率与孕周、超声医师技术水平、仪器的灵敏度密切相关。     

产前彩色超声筛查胎儿畸形的临床价值

目的评价产前彩色超声筛查胎儿畸形的临床价值。方法回顾性分析分娩及引产的40例畸形胎儿的临床资料,经腹壁按顺序排查法进行超声检查,观察超声诊断胎儿畸形率。结果彩色超声检出符合率约90.0%,漏诊率为10%。检出先天性心脏畸形10例,发生率达25.0%,神经系统畸形、唇裂检出率均为17.5%。结论产前超声筛查可以发现胎儿严重的结构畸形,为临床提供重要的信息,具有重要的诊断价值,是产前诊断的首选方法。     

超声在诊断胎儿先天性肺囊腺瘤畸形中的应用

目的 探讨超声对胎儿先天性肺囊腺瘤畸形的诊断价值,提高先天性肺囊腺瘤的产前诊断率.方法 对产前经彩色多普勒超声诊断的20例胎儿肺囊腺瘤畸形的声像图特征进行回顾性分析,并进行产后追踪随访.结果 产前超声诊断出的20例肺囊腺瘤畸形胎儿,病灶均为单侧,其中Ⅰ型2例,Ⅱ型6例,Ⅲ型12例.2例伴有腹腔积液,1例伴有胎儿水肿,1例伴有心脏畸形.结论 超声检查作为一种无创性检查方法,是发现胎儿先天性肺囊腺瘤最有效的方法之一,具有重要的临床意义.     

产前超声检查对中晚孕期胎儿畸形筛查的诊断价值

目的:分析产前超声检查对中晚孕期胎儿畸形筛查的诊断价值。方法:选取2015年3月~2017年4月我院接诊的中晚孕期孕妇648例为研究对象,均行产前超声检查,以分娩及引产结果为金标准,探讨产前超声检查对中晚孕期胎儿畸形筛查的诊断价值。结果:分娩及引产结果证实,648例胎儿中,胎儿畸形15例,其中心脏畸形2例,泌尿系统畸形1例,消化系统畸形1例,体表畸形7例,确诊中枢神经系统畸形后引产4例,胎儿畸形发生率为2.31%;产前超声检查648例胎儿中,胎儿畸形14例,其中心脏畸形2例,泌尿系统畸形1例,消化系统畸形1例,体表畸形6例,确诊中枢神经系统畸形后引产4例。产前超声诊断准确率为99.23%,灵敏度为80.00%,特异度为99.68%。结论:超声检查对诊断胎儿畸形具有重要价值,是产前诊断的首选方法 。     

Prenatal screening

The prenatal period is an ideal time to look at screening issues in an effort to maximize the health of the woman and effect a good outcome for her baby. As primary care providers for family, it is important to look beyond a traditional medical model for screening to examine a woman in the context of her family and her experiences. This article takes a broader view of screening to include some social and family issues. It also seeks to examine the evidence around some of the controversial issues in screening to help the provider be a thorough advisor to his or her patients.     

Prenatal screening

Routine obstetric screening for all patients should include a Pap smear, urinalysis and urine culture, complete blood count, blood type, Rh factor and direct Coombs' test. Patients should also be screened for syphilis, rubella, gonorrhea and diabetes. For patients at high risk for certain conditions, additional studies of value include obstetric ultrasound, amniocentesis, serum alpha-fetoprotein level and screening for sickle cell anemia, herpes, hepatitis B, Chlamydia and human immunodeficiency virus.     

Prenatal Imaging

Rapid developments have occurred in the area of prenatal imaging over the last few decades. Advances have occurred in prenatal ultrasound as well as magnetic resonance imaging (MRI). Each modality has benefits and limitations. This article explores the rationale, safety, and indications for each imaging modality. Prenatal imaging also impacts parental bonding and psychological status. The improved imaging techniques may both assist in parental counseling, as well as identify abnormalities of unclear consequence. It is paramount that parents understand both the benefits and limitations of these imaging modalities.     

Prenatal Pediatrics

Samples of maternal and fetal plasma maybe used to evaluate changes in fetal tissues which are secondary to intravenous therapy administered to the mother.

Transient fetal bradycardia accompanying normal uterine contractions results from transient hyperactivity of the vagus nerve, which is caused by increased intracranial pressure secondary to pressure on the fetal head and a reduced rate of perfusion of fetal blood through the medulla.

Oxygen administered routinely to the mother in the last 15 minutes or so before delivery may be a most effective means of preventing fetal birth injury.