产前超声诊断单脐动脉与胎儿异常的相关性研究

目的探讨超声检测胎儿脐带血管数目预测胎儿先天异常的价值。方法2000年1月至2006年10月在中山大学附属第一医院采用超声检测胎儿脐血管数目，对单脐动脉胎儿行产前超声系统筛查及胎儿染色体检查；分析单脐动脉合并畸形类型，与染色体异常的关系及胎儿结局。结果产前超声诊断胎儿单脐动脉119例，包括左侧72例（60．5％），右侧47例（39．5％）。单纯性单脐动脉59例（49.6％）；合并其他结构畸形60例（50．4％），其中泌尿系统畸形25例（41．7％），心血管系统畸形17例（28.3％），中枢神经系统畸形15例（25.0％），下肢畸形9例（15．0％），前腹壁和消化道畸形各5例（各占8．3％），唇裂或唇腭裂畸形3例（5．0％），其他畸形3例（5．0％）。行胎儿染色体检查41例，发现染色体异常8例，包括18-三体综合征3例、13-三体综合征1例、21．三体综合征1例、染色体片段异常3例，均合并其他畸形。结论胎儿单脐动脉左侧发生率高于右侧，约50％合并其他畸形；合并畸形时，染色体异常发生率较高；大部分单纯性单脐动脉胎儿结局良好。

Relationship between fetal malformation and single umbilical artery diagnosed before pregnancy

Objective To evaluate the value of single umbilical artery(SUA)in predicting fetal congenital malformations.MethodsFrom Jan.2000 to Oct.2006,SUA was diagnosed in 119 fetuses in the First Affiliated Hospital of Sun Yet-sen University.Color flow imaging of the fetal pelvis was used to determine the number and side of umbilical arteries.The associated anomalies,karyotype,Doppler findings and perinatal outcome of the fetuses with SUA were analyzed.ResultsSUA was diagnosed in 119 cases.The right umbilical artery was absent in 72(60.5%),and the left in 47(39.5%).SUA as an isolated finding occurred in 59(49.6%)fetuses,and 60(50.4%)cases had associated malformations.The abnormalities included 25(41.7%)urinary system anomalies,17(28.3%)cardiovascular anomalies and 15(25.0%)central nervous system anomalies.Chromosomal defects were diagnosed in eight of 41 cases that accepted karyotype examination,including three cases of trisomy 18,one case of trisomy 13,one case of trisomy 21 and three cases of other chromosomal defects.ConclusionOur data suggest that in fetuses with SUA,the absent artery of the right side is more frequent than that of the left.About half of the fetuses with SUA are associated with congenital malformations.Chromosomal abnormalities happen more frequently in SUA accompanied with other anomalies.The perinatal outcome is normal in most of the fetuses with isolated SUA.