产前系统超声检查与三维/四维在胎儿畸形诊断中的意义

目的探讨二维产前系统筛查联合四维超声对产前诊断胎儿畸形的临床价值。方法我院2010年1月～2011年2月采用二维超声对11 230例孕妇,在孕22-26周进行产前系统筛查,其中汉族6170人,维吾尔族5060人,对疑似有胎儿畸形的孕妇联合应用四维超声进行诊断,并根据引产或胎儿出生后的随访结果评价其诊断率。结果 11 230例孕妇共娩出11 280(其中双胎50例)胎儿,经单纯二维超声发现畸形365例,二维与四维联合诊断的畸形391例,该组经临床证实共有的畸形407例,联合诊断的符合率为96.1%,显著高于单纯二维89.6%,P<0.05。结论二维超声是诊断胎儿畸形的首选检查方法,四维超声可动态观察胎儿体表畸形的部位,两者联合应用可以大大提高产前胎儿畸形的诊断率,有效降低出生缺陷,值得临床推广。

Prenatal ultrasonic inspection system and four dimensional ultrasound significance discussionin diagnosis of fetal malformation

Objective： To assess the clinical value of two -dimensional uhrasonography （2DUS） combined with four -dimensional ultrasound （4DUS） in evaluating fetal malformation in prenatal diagnosis. Method： Totally 11 230 pregnant women underwent prenatal systematic ultrasonic examination, when their pregnancy week between 22 -26, during January 2010 to February 2011. Among them, 6170 are Han people, 5060 are Uigur. The pregnancy women who suspected had fetal malformation were diagnosised with four - dimensional ultrasound, and evaluated this diagnostic rate based on follow - up results. Result ： 11 230 pregnancy women parturitioned 11 280 foetus （50 twins）, 365 cases were discovered malformation on simplicity two -dimensional ultrasonography, and 391 cases were discovered on combined diagnosis with two - dimensional and four - dimensional uhrasonography, 407 cases were authenticated by clinic. Combined diagnostic accuracy was 96. 1%, significantly greater than simplicity two - dimensional uhrasonography （89. 6% , P 〈0. 05）. Conclusion： Two - dimensional ultrasonography diagnosis is the preferred method for fetal malformation examination, four - dimensional ultrasonography can observe fetal surface deformity dynamically, we can significantly improve the diagnosis rate by combined two method, to reduce birth defect efficiently, deserve the clinical expansion.