胎儿泌尿系畸形的产前超声诊断及预后评估

目的 探讨超声诊断胎儿泌尿系畸形的声像图特征及其临床实用价值。方法 按产科超声常规检查胎儿，发现胎儿泌尿系统异常者，根据声像图特征评估处理。结果 52例产前超声可疑为泌尿系畸形患者中，13例考虑到泌尿系畸形可能为致命性病变而终止妊娠，10例因一侧肾病变而自愿引产，12例胎儿出生后随访肾盂积水消失，7例胎儿肾盂扩张大于1．5cm，考虑输尿管狭窄出生后经手术治疗，1例胎儿单侧肾囊肿因合并心脏严重畸形出生后死亡，8例胎儿一侧肾脏异常、另一侧形态及结构未发现异常后均自然分娩，1例胎儿于孕24周可疑婴儿型多囊肾后经复查排除。结论 产前超声诊断胎儿泌尿系畸形，依靠特有的声像图改变及合并其他畸形，对胎儿预后判断、临床及早采取措施提供依据，这对优生优育及新生儿早期治疗有重要临床实用价值。

Prenatal Sonography for Screening Fetal Urinary Tract Anomalies and Evaluating Their Prognosis

Objective To investigate the sonographic characteristics and clinical value of fetal genitourinary system malformation and the fetal prognosis. Methods All refered fetuses were accepted routine obstetric B-mode ultrasonographic scan. Fetuses who had abnormality in urinary system, were evaluated and handled according to the sonographic characteristics. Results Of 52 cases suspected as fetal urinary tract anomalies, 13 pregnant women were terminated because the urinary tract anomalies was considered fatal; 10 pregnant volunteered to be preinduced for pathological changes in single kidney ; 12 fetuses who were considered hydronephrosis recovered after birth ; 7 fetuses whose renal calyces expanded to 1.5 cm were diagnosed ureter stricture and were operated after birth; one infant who was diagnosed single renal cyst died after birth because of serious heart abnormalities; 8 fetuses were naturally delivered whose one kidney was normal but another with abnormalities; 1 case who was suspected polycystic renal disease in gestation 24 weeks was negtive after following-up. Conclusions Sonography for fetal urinary tract anomalies screening may aid to to improve birth quality and aristogenics.