产前不同时期三维超声筛查胎儿唇裂的效果比较

目的 探讨产前不同时期三维超声筛查胎儿唇裂畸形的效果。方法 选择2007年8月至2014年6月在衡阳市第一人民医院进行产前检查并确诊胎儿为唇裂的孕妇31例，对其二维图像及三维成像进行对比，研究三维成像对胎儿唇裂的显示率及最佳显示时间。结果 31例唇裂中，孕14～19周5例，面部三维成像满意者3例，唇部结构清晰显示者2例（唇裂的三维超声显示率40．0％）；孕20～27周17例，面部三维成像满意或基本满意者15例，唇部结构清晰显示者15例（三维超声显示率88．2％）；孕28～34周6例，面部三维成像满意或基本满意者3例，唇部结构清晰显示者2例（三维超声显示率33．3％）；孕35周～39周3例，仅1例羊水过多患者面部三维成像满意，唇部结构显示清晰（三维超声显示率33．3％）。孕20～27周胎儿唇裂三维成像显示率明显高于孕14～19周（χ^2=5．119，P＝0．024）、28～34周（χ^2=6．933，P＝0．008）和35～39周（χ^2=4．804，P＝0．028），差异均有统计学意义。三维成像满意显示的唇裂中Ⅰ度唇裂3例（15．0％），Ⅱ度唇裂4例（20．0％），Ⅲ度唇裂7例（35．0％），唇裂合并上牙槽突裂3例（15．0％），唇裂合并腭裂3例（15．0％）。结论 三维超声诊断胎儿唇裂存在明显的时限性，最佳时间为孕20～27周。

Comparison of prenatal 3D ultrasound screening at different periods for fetal cleft lip

Objective To study the effect of 3D ultrasound screening for fetal cleft lip deformity at different periods .Methods Totally 31 pregnant women ,who had done prenatal examination in the First People ’ s Hospital of Hengyang City during the period of August 2007 to June 2014,were diagnosed with cleft lip .Their 2D images and 3D images were compared to study the display rate and the optimal display time of fetal cleft lip by 3D imaging.Results Of 31 cases of cleft lip, 5 cases were pregnancy at 14-19 gestational weeks, including 3 cases with facial 3D imaging, 2 cases with lip structure clear display （the 3D ultrasound display rate of cleft lip was 40.0%）.There were 17 cases of pregnancy at 20-27 gestational weeks, including 15 cases with satisfied or basically satisfied facial 3D imaging and 15 cases with lip structure clear display （ the 3D ultrasound display rate was 88.2%）.There were 6 cases of pregnancy at 28 -34 gestational weeks, including 3 cases with satisfied or basically satisfied facial 3D imaging and 2 cases with lip structure clear display （ the 3D ultrasound display rate was 33.3%）.Three cases were at 35-39 gestational weeks and only one case of amniotic fluid has satisfied facial 3D imaging and clear display of lip structure （the 3D ultrasound display rate was 33.3%）.The 3D imaging display rate of fetal cleft lip at 20-27 gestational weeks was significantly higher than that at 14 -19 gestational weeks （χ^2=5.119,P=0.024）, 28-34 gestational weeks （χ^2=6.933,P=0.008） and 35-39 gestational weeks （χ^2=4.804,P=0.028）, and the differences were significant .Among cleft lip with satisfied 3D ultrasound imaging there were 3 cases of I degree （15.0%）, 4 cases of II degree （20.0%）, 7 cases of III degree （35.0%）, 3 cases of cleft lip combined with upper alveolar cleft （15.0%） and 3 cases with cleft lip and cleft palate （15.0%）. Conclusion Three-dimensional ultrasonography in diagnosis of fetal cleft lip has time limit and the best time is at 20-27 gestational