早孕末期超声筛查对复发性流产史孕妇的胎儿结构异常意义

目的分析早孕末期超声筛查对有复发性流产史孕妇筛查的价值。方法2008年1月-2010年12月在中山大学孙逸仙纪念医院行11～13撕孕周超声检查的孕妇1731例，对照组f无特殊病史，以下相同）1421例、复发性流产史组310例。超声筛查胎儿结构异常共78例，对照组57例，复发性流产史组21例。其中包括既往3次及以上流产史的孕妇18例。结果对照组超声筛查胎儿结构异常检出率为4．01％（57／1421），复发性流产史组检出率为6．77％（21／310）。两组检出率比较，差异有显著性（x^2=4．515，P=0．034）。两组异常都主要是颈部异常。既往3次及以上流产史的孕妇超声检查胎儿结构异常的比例为85．71％。结论有复发性流产史（特别是流产3次及以上）的孕妇更有必要做早孕末期超声筛查，并着重检查颈部异常。

Significance of ultrasound screening of fetal structural abnormalities in pregnant women with history of recurrent pregnancy loss in the late first trimester

Objective To analyse the screening value of ultrasound in pregnant women with history of recurrent pregnancy loss in the late first trimester.Methods 1,731 pregnant women at 11 to 13 +6 gestational weeks who had received prenatal ultrasonic examination in Sun Yat-sen memorial hospital during the period of January 2008 to December 2010 were included in this study,1,421 of whom did not have special medical history (control group) and 310 had history of recurrent pregnancy loss (pregnancyloss group).Fetal structural abnormalities were found in 78 women (57 in the control group and 21 in the pregnancy-loss group),including 18 with history of abortion of three times or more.Results The detection rate of fetal structural abnormalities differed significantly between the control group and the pregnancy-loss group (4.01％ vs.6.77％ or 57/1,421 vs.21/310; x2=4.515,P=0.034).The major malformation was neck abnormalities.85,71％ of the women with history of abortion of three times or more developed fetal structural abnormalities.Conclusions Pregnant women with history of recurrent pregnancy loss (especially for three times or more) are necessary to have ultrasound screening in the late first trimester.Neck abnormalities is a focus for the ultrasonic examination.