产前超声诊断胎儿肢体畸形的技术探讨

目的　探讨通过产前超声提高胎儿肢体畸形诊断率的操作技巧。 方法　采用连续顺序追踪法对2014年1月至2015年1月142,17例孕16～37周孕妇常规行胎儿肢体超声成像。 结果　全部胎儿中发现肢体畸形41例，检出率为0.28%，其中包括肢体大部分缺失1例，肢体部分缺失4例，桡骨缺失6例，马蹄内翻足9 例，裂手畸形2例，腓骨缺失2例，多指（趾）2例，羊膜束带综合征2例，手姿势异常4例，先天性多发性关节挛缩2例，并腿畸形3例，严重短肢畸形4例。漏诊16例，占所有畸形的28%，包括7例并指畸形，5例多指（趾）畸形，4例重叠指，误诊2例马蹄内翻足，均经引产或出生后证实。 结论　产前超声能直观显示胎儿肢体结构，是诊断胎儿肢体畸形的首选方法，熟练的操作技术及操作技巧是产前超声诊断胎儿肢体畸形的关键。

Evaluation of skill and experience in diagnosis of fetal limb deformities by Prenatal ultrasound

Objective　 To explore the scanning skill of prenatal ultrasound in improving diagnostic rate of fetal limb deformities.　Methods　The continuous order tracking method was adopted,14,217 women with pregnancy ranging from 16 to 37 weeks were examined by ultrasound scan of fetal limbs in our hospital from January 2014 to January 2015.　Results　In 14,217 cases of pregnant women, 41 cases were found with limb malformations, the detection rate being 0.28%, including 1 severe body defect, 4 body defect, 6 radial deficiency, 9 talipes equinovarus, 2 hand posture malformation, 2 fibula deficiency, 2 congenital multiple joints contracture, 3 sireniform fetus； 16 cases were misdiagnosed, accounting for about 28% of all abnormalities，including 7 syndactylism, 5 polydactylism, 4 overlapping hands, 2 talipes equinovarus. All were confirmed by induced labor or after birth.　Conclusions　Prenatal ultrasound could display fetal limb structure,and should be chosen as the first preferred diagnostic method forfetal limb deformities. Adeptness and high expertise in operation arethe key to the prenatal ultrasound examination.