经腹和经阴道彩超联合技术对重型α-地中海贫血胎儿的产前早期诊断

目的探讨经腹和经阴道彩超联合技术对重型α-地中海贫血胎儿的早期产前诊断的效果。方法选取我院妇产科门诊2014年12月~2017年12月收治的产检的孕12~26周孕妇153例，采用经腹羊水穿刺术或绒毛膜穿刺术对胎儿进行α-地中海贫血诊断，同时采用腹部联合阴道彩色超声技术对其进行检查，对比两次诊断结果。结果经腹部和阴道彩色超声联合技术对重型α-地中海贫血胎儿检测灵敏度为98.96%（95/96），假阳性率为1.04%（1/96），特异度为92.98%（53/57），假阴性率为7.02%（4/57）。在超声图像中可清楚的看到患病胎儿浆膜腔积液、心脏增大、心胸比增大的现象，并且有颈部透明层增厚，肠管回声增强，胎盘增厚等现象。结论将经腹和经阴道彩超联合技术运用于早期产前诊断，能较准确的诊断出重型α-地中海贫血胎儿，值得临床的推广应用。

Application of trans-abdominal and transvaginal color Doppler ultrasound in the early prenatal diagnosis of alpha-thalassemia major fetus

ObjectiveTo explore the effect of trans-abdominal and transvaginal color Doppler ultrasound on the early prenatal diagnosis of alpha-thalassemia major fetus.Methods153 cases of pregnant women at 12-26 gestational weeks who underwent prenatal examination at our hospital from December 2014 to December 2017 were included. Alpha-thalassemia diagnosis of fetus was carried out on each case via trans-abdominal amniocentesis or puncture of chorionic membrane; in the meantime, trans-abdominal and transvaginal color Doppler ultrasound was applied to examine the fetus. The results of both approaches were compared.ResultsThe detection sensitivity, false positive rate, specificity, and false negative rate of trans-abdominal and transvaginal color Doppler ultrasound for alpha-thalassemia major fetus were 98.96% (95/96), 1.04% (1/96), 92.98% (53/57) and 7.02% (4/57) respectively. Radiographic images displayed clearly the serous cavity effusion, cardiac enlargement and increase of cardiothoracic ratio of the fetus, while other phenomenon, including the increase of nuchal translucency, bowel echo enhancement and thickening placenta, were also detected.ConclusionThe application of trans-abdominal and transvaginal color Doppler ultrasound in the early prenatal examination can accurately diagnose alpha-thalassemia major fetus, thus worthy of clinical application.