产前超声诊断单脐动脉的临床价值

目的探讨单脐动脉的产前超声诊断及其临床价值。方法对产前超声检查中发现的40例单脐动脉胎儿进一步进行全面筛查,并行脐血染色体检查,对妊娠结局进行随访。结果 40例单脐动脉中,单纯性单脐动脉28例(70%),合并其他畸形12例(30%),其中心血管系统畸形3例,中枢神经系统畸形2例,泌尿系统畸形2例,多发性畸形2例,消化系统畸形、桡骨发育不良及膈疝各1例;接受脐血染色体检查7例,染色体核型异常3例;单纯性单脐动脉预后良好。结论产前超声可以明确诊断单脐动脉。单脐动脉合并其他畸形的发生率高于正常,合并畸形时染色体异常发生率增高。当超声检查发现单脐动脉时,应进一步作系统筛查及染色体检查,并对单脐动脉胎儿生长发育指标进行监测评估,均具有重要的临床意义。

Clinical significance in prenatal diagnosis of fetal single umbilical artery

Objective： Discuss the clinical significance of prenatal diagnosis of single umbilical artery. Method： Completely screening analysis of 40 eases of fetuses with single umbilical artery found throughout regular prenatal ultrasound tests, which include tests in amniotie fluid and chromosome from fetal umbilical blood. Conduct follow - ups on outcomes of pregnancy. Result ： In 40 fetuses with single umbilical artery, there are 28 eases （70%） with isolated finding of single umbilical artery; 12 eases （30%） with some fetal anomalies which include 3 fetuses with cardiovascular anomalies ; 2 fetuses with defects of central nervous system ; 2 fetus with Urinary system; 2 fetus with multiple abnormalities; 1 fetus with digestive system defect; 1 fetus with radius dysplasia; 1 fetus with diaphragm hernia ; and 3 fetuses with chromosome abnormalities. The isolated finding of single umbilical artery presents satisfactory result. Conclusion： Using prenatal ultrasound to found a fetus with single umbilical artery is significant. There is a high risk and increasing chances of other fetal abnormalities when finding fetuses with single umbilical artery. Therefore, when finding fetuses with single um- bilical artery though ultrasound test, it is clinically significant to assess fetal structure systematically, as well as chromosome and follow up growth of fetuses with single umbilical artery.