产前超声对孕14周内胎儿肢体畸形的诊断价值
Diagnostic value of the prenatal ultrasound for fetal limb malformation within 14 weeks of pregnancy
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摘要: 目的：探讨产前超声对孕14周内胎儿肢体畸形的诊断价值。方法：选取2013年5月至2015年5月行孕期检查的1 970例早孕期孕妇，在孕14周和孕24周对入选孕妇各进行1次产前超声检查，2次检查均对胎儿肢体的形态、结构、姿势及运动等进行连续顺序追踪超声法观察，对分娩后新生儿进行定期随访，对于引产后胎儿的尸体进行尸检。结果：所有胎儿肢体超声声像图均清晰满意。早孕期检测出肢体异常的胎儿共20例，漏诊肢体畸形胎儿9例，被误诊为先天性马蹄内翻足胎儿1例，早孕期对胎儿实施超声检查的肢体畸形检出率为68.9%（20/29）；中孕期再次检出胎儿肢体畸形6例，修正早孕期误诊1例。2次超声检查对胎儿肢体畸形检出率为89.7%（26/29）。在早孕期检出的肢体畸形胎儿中有3例合并有鼻骨缺失，有3例合并有颈部水囊瘤。且仅37.9%（11/29）胎儿伴有颈项透明层值增厚和静脉导管血流频谱的改变。结论：大部分严重的胎儿肢体畸形均可使用超声检查及时诊断出，从而对畸形胎儿作出正确有效的宫内治疗或引产。Abstract: Objective:To investigate the diagnostic value of the prenatal ultrasound for fetal limb malformation within 14 weeks of pregnancy.Methods:One thousand nine hundred and seventy early pregnancy women from May 2013 to May 2015 were investigated.The pregnant women were examined using ultrasound at 14 weeks and 24 weeks of pregnancy,and the morphology,structure,posture and movement of fetuses were observed using the systematic continuous sequence approach.The newborn was regularly followed up,and the autopsy of the fetus corpse after induced labor was implemented.Results:The ultrasonography of all fetal limbs was clear.The limb malformation in 20 cases,missed diagnosis of fetal limb deformity in 9 cases and misdiagnosis of congenital clubfoot in 1 case were identified,and the detection rate of fetus limb malformation was 68.9%(20/29) in early pregnancy.The fetal limb deformity in 6 cases and correcting the misdiagnosis of early pregnancy in 1 case were found in the second detection,the detection rate of two times in fetus limb malformation was 89.7%(26/29).In the early pregnancy detection of fetal limb malformation,the fetal limb malformation complicated with nasal bone loss in 3 cases,neck hygroma in 3 cases,and nuchal translucency thickening and venous flow spectrum change in 37.9%(11/29) fetuses were found.Conclusions:Most severe fetal limb deformities can be diagnosed by ultrasonography in time,which can make a correct guidance to implement effective intrauterine treatment or induction of labor.
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Key words:
- fetal disease /
- ultrasonic examination /
- limb deformity /
- gestational age /
- diagnostic value
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