438例胎儿和围产儿尸检中先天畸形的临床病理分析

目的通过病理解剖检查,探讨胎儿和围产儿先天畸形的发生情况及临床病理特点。方法回顾性分析我院2005年1月至2010年12月438例产科和儿科的围产儿及胎儿尸检资料和临床资料,对先天性畸形及主要死因进行分析。结果临床诊断与病理解剖诊断符合率为92.00%。438例围产儿及胎儿尸检中畸形检出率85.84%(376/438),最常见为神经系统(76例)和循环系统(72例),其次为头面五官(42例)、运动骨骼(32例)、泌尿生殖(30例)、呼吸(25例)、染色体病(26例)、消化(20例)等系统畸形。其中单一畸形64.63%(243/376),多发畸形35.37%(133/376)。结论先天畸形是影响围产儿及胎儿死亡的重要因素。病理解剖检查是确诊胎儿畸形及明确死因的有效手段。

Clinical pathologic analysis for congenital malformations in 438 cases of fetal and perinatal autopsy

Objective To investigate the incidence and clinical pathologic features of congenital malformation in fetuses and perinatal infants through anatomical pathological examination.Methods A total of 438 autoptical specimens of fetuses and perinatal infants were collected from the Departments of Obstetrics and Pediatrics in our hospital during January 2005 to December 2010.Their autopsy and clinical data were analyzed for congenital malformation and main causes of death of neonatal.Results The coincidence rate of clinical diagnosis and pathological anatomy diagnosis was 92%.The incidence of congenital malformation in autopsy for 438 cases of fetal and perinatal infants was 85.84%(376/438).The incidence of congenital malformations was 17.35%(76/438) in neural system,and 16.44%(72/438) in circulatory system,followed by cleft of lip and palate(42/376),motorial system(32/376),urinary system(30/376),respiratory system(25/376),chromosomal disorder(26/376)and digestive system(20/376).Among these 376 cases,the cases of single malformation accounted for 243(64.63%),while the cases of multiple deformities were 133(35.37%).Conclusion Congenital malformation is the most important cause for mortality in fetuses and perinatal infants.Clinical pathological anatomical examination is a useful tool to diagnose congenital fetal malformation and to verify causes of fetal death.