单脐动脉与伴发畸形的关系及胎儿围生期预后

目的 探讨单脐动脉(SUA)与其伴发畸形的关系及单纯SUA对胎儿生长发育的影响。 方法 回顾性分析产前超声筛查的12 542胎,将其中92胎SUA分为2组:单纯SUA组(A组,n=46)及SUA合并畸形组(B组,n=46)。正常组(C组)为与SUA胎儿同期出生、经随访追踪无异常的46胎。观察SUA合并畸形的种类和比例,对比A、B组SUA胎儿围生期死亡率,并分析SUA胎儿与正常胎儿出生时的体质量、体长及孕龄等。 结果 B组围生期死亡率(78.26%, 36/46)显著高于A组(2.17%, 1/46, P<0.01)。SUA伴发畸形几乎涵盖所有系统,与多种严重复杂畸形相关联。与正常胎儿相比,SUA胎儿出生体质量、体长及孕龄较正常胎儿偏小,但胎儿宫内生长受限(FGR)及小于胎龄儿(SGR)发生率的差异无统计学意义。 结论 SUA可伴发多种畸形;SUA伴发畸形胎儿的围生期死亡率显著高于单纯SUA,后者因脐带动脉的代偿功能而相对预后良好。

Relationship between single umbilical artery and associated congenital anomalies, and the prognosis of perinatal period

Objective To observe the relevance of single umbilical artery (SUA) and fetal congenital malformations, as well as the impact of SUA to fetus in growth and development. Methods Totally 12 542 fetuses underwent prenatal ultrasonography, among them 92 SUA were diagnosed and divided into group A (single SUA, n=46) and group B (SUA combined with congenital malformations, n=46), while 46 normal fetuses birth in the same time were enrolled in group C. The ratio and kinds of combined malformations of SUA were observed, the perinatal mortality of group A and B were compared, the birth record of birth body weight, stem length and gestational age of group A and B were analyzed and compared to those of group C. Results The perinatal mortality of group B (78.26%, 36/46) was obviously higher than group A (2.17%, 1/46, P<0.01). SUA combined malformations could occur in almost every organ and system. Many kinds of severe and complex malformations were relevant with SUA. The birth body weight, stem length and gestational age of SUA fetuses were smaller than those of normal fetuses. However, the incidence of fetal growth restriction (FGR) and small generational age (SGR) were not statistical difference between SUA and normal fetuses. Conclusion Many kinds of congenital malformations accompany SUA. The perinatal mortality of SUA with congenital malformations ias obviously higher than single SUA. The prognosis of single SUA is relatively good since the compensate blood flow of the remaining umbilical artery.