胎儿骨骼畸形的超声诊断与临床价值

目的 总结22例胎儿各类骨骼畸形的超声检查，探讨其声像特征及临床应用价值。方法 对8591例妊娠16～40周的孕产妇常规超声检查，胎儿四肢根据其解剖结构和邻周关系，长短轴切面结合，多角度追踪扫查。发现胎儿骨骼畸形声像特征，即作动态观察，确认后予测量记录，引产或产后对照。结果 产前超声确诊胎儿骨骼畸形21例，与引产后死婴以及分娩新生儿对照，完全符合19例，准确率86．4％(19／22)。基本符合2例，占9.1％(2／22)。1例胎儿水肿综合征漏诊其双足内翻畸形，占4．5％(1／22)。结论 超声检查可提示胎儿致死性和严重骨骼畸形的形态学特征，为产科合理干预提供可靠诊断依据，具有临床应用价值。

Ultrasonic Diagnosis and its Clinical Application for Fetal Bone Malformation

Objective To summarize the ultrasonic diagnosis of 22 caeses with various kinds of fetal bone malformation and to discuss the acoustic image characteristics and their clinical application.Methods Routine ultrasonic examination was carried out on 8591 cases of pregnant women in their 16th to 40 th week of pregnancy.According to the anatomical characteristics of the fetal limbs,integrating the long and short axes,and examining from different angles,we summarized the acoustic image characteristics of the fetal bone malformation.Periodical observations were performed on these cases;measurements were recorded and compraed with the induced labor or post partum situations.Results Twenty-two cases with fetal bone malformation were diagnosed via ultrasound antepartum among which 19 cases were fully consistent with their postpartum results,with an accuracy rate of 86.4%(19/22);2 cases were partially consistent,with an accuracy rate of 9.1% (2/22);1 case 4.5%,(1/22) resulted in a fetal edema syndrome which was missed diagnosed its strephenopodia abnormality.Conclusions Ultrasonic examination can point out morphological characteristics of fatal structures and serious bone malformations and provide a diagnostic basis for obstetric intervention,and be valuable for minimizing the neonatal mortality.