二维、三维超声结合诊断胎儿畸形的临床价值

目的对产前二维、三维超声诊断胎儿畸形的临床价值进行探讨分析,进一步起到指导今后胎儿畸形检测的作用。方法回顾性分析2012年11月—2014年1月在浙江省绍兴市上虞妇幼保健院进行检查的9456例妊娠12-38周孕妇,首先进行常规二维超声检查、记录,疑似胎儿发育异常者行三维成像,采集胎儿立体、运动图像。结果经引产或出生后证实各种畸形共146例,发生率为1.54%（146/9456）,二维超声检出率为83.56%（122/146）,低于三维超声的95.89%（142/146）（P〈0.05,χ^2=12.037）,三维超声检查漏诊6例,漏诊率为4.11%（4/146）,胎儿畸形累计所有系统,如中枢神经系统、心血管系统、泌尿系统、消化道系统等,其中心血管系统所占比例最高,占17.8%（26/146）,其次是泌尿生殖系统16.4%（24/146）、中枢神经系统15.8%（23/146）。结论产前超声检查是诊断先天性胎儿畸形的主要手段,具有重要的诊断价值。

Utility of Two-and Three-Dimensional ultrasound in diagnosis of fetal malformation

Objective To discuss the clinical value of two-dimensional ultrasound combined with three-dimensional ultrasound in the diagnosis of fetal malformation,and further improve the diagnostic accuracy. Methods The data of 9456 cases of 12- 38 weeks pregnant in our hospital from November 2012 to January 2014 were retrospectively analyzed. The conventional two-dimensional ultrasound was performed in all pregnant,for the suspected fetal malformation,three-dimensional ultrasound was conducted to acquire fetal stereo and movement images. Results A total of 146 patients was confirmed as having malformations by induced labor or after the birth with an incidence rate of 1. 54%; the detection rate of two-dimensional ultrasound was 83. 56% which was significantly less than 95. 89% of three-dimensional ultrasound（ P〈0. 05,χ^2= 12. 037）; there were 6 cases of misdiagnosis using three-dimensional ultrasound examination,with a false dismissal rate of 4. 11%; fetal abnormalities accumulated in all systems,such as in the central nervous system,heart,urinary system and digestive system,etc. The highest proportion was the cardiac abnormalities,accounting for 17. 8%（ 26 /146）,followed by urinary reproductive system 16. 4%（ 24 /146） and nervous system 15. 8%（ 23 /146）. Conclusion Prenatal ultrasonography is a major means to diagnose fetal malformation,which has important diagnostic value.