彩色多普勒超声在鹤山市孕早期胎儿畸形筛查的应用价值
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摘要
目的探讨彩色多普勒超声在鹤山市孕早期胎儿畸形筛查的应用价值。方法选取2016年3月～2017年7月于我院行孕早期超声检查孕妇2000例,追踪其妊娠结局,并收集其静脉导管血流频谱、三尖瓣血流频谱、颈项透明带厚度(NT)、鼻骨长度等临床资料,同时对胎儿头颅、心脏、胃泡及四肢等结构进行观察。根据异常胎儿父母是否终止妊娠的意愿,对继续妊娠孕妇进行孕中期检查,并追踪其妊娠结局。结果经孕早期超声筛查后,2000例孕妇中62例异常胎儿因其畸形程度较为严重而选择终止妊娠;筛查的孕妇人群中有80例双胞胎孕妇检查结果未发现异常。2000例孕妇在孕早期经超声检查发现异常胎儿137例,异常检出率为6.85%;137例异常胎儿中胎儿严重畸形者62例(45.26%)终止妊娠。1938例继续妊娠孕妇在孕中期超声检查中发现94例(4.85%)胎儿异常,其中24例心脏畸形,18例泌尿系统畸形,14例颜部畸形,13例中枢神经系统畸形,11例肢体畸形,其余畸形14例。结论孕早期超声检查对早发性、严重性异常胎儿的筛选效果显著,具有较高的临床应用价值,但孕早期超声检查无法代替孕中期超声诊断。
Objective To explore the application value of color Doppler ultrasound in the screening fetal malformations in early pregnancy in Heshan. Methods 2000 pregnant women who underwent ultrasound examination in early pregnancy in our hospital from March 2016 to July 2016 were selected.The pregnancy outcome was tracked.The blood flow spectrum of the venous catheter,blood flow spectrum of tricuspid valve,nuchal translucency(NT) thickness,length of nasal bones and other clinical data were collected.Meanwhile,the fetal head,heart,stomach vesicles,limbs and other structures were observed.According to the willingness of the abnormal fetal parents to terminate the pregnancy,the pregnant women who continued to have a pregnancy were examined in the second trimester and their pregnancy outcomes were tracked. Results After ultrasound screening in early pregnancy,62 of the 2000 pregnant women were selected for termination of pregnancy due to their more severe deformity.In the screening group,80 twin pregnant women had no abnormalities in the results of the examination.In 2000 pregnant women,137 cases of abnormal fetuses were found by ultrasound in early pregnancy,and the abnormal detection rate was 6.85%.Of the 137 abnormal fetuses,62(45.26%) of the severe fetal malformations terminated the pregnancy.In 1938 consecutive pregnant women,94(4.85%) fetal abnormalities were found in ultrasound examination of the second trimester,including 24 cases of cardiac malformations,18 cases of urinary malformations,14 cases of facial deformities,13 cases of central nervous system malformations,11 cases of limb malformations and 14 cases of other deformities. Conclusion Ultrasound examination in early pregnancy has a significant screening effect on early-onset and severely abnormal fetuses and it has high clinical values.However,pregnancy ultrasound in early pregnancy can't replace ultrasound diagnosis in the second trimester.
Objective To explore the application value of color Doppler ultrasound in the screening fetal malformations in early pregnancy in Heshan. Methods 2000 pregnant women who underwent ultrasound examination in early pregnancy in our hospital from March 2016 to July 2016 were selected.The pregnancy outcome was tracked.The blood flow spectrum of the venous catheter,blood flow spectrum of tricuspid valve,nuchal translucency(NT) thickness,length of nasal bones and other clinical data were collected.Meanwhile,the fetal head,heart,stomach vesicles,limbs and other structures were observed.According to the willingness of the abnormal fetal parents to terminate the pregnancy,the pregnant women who continued to have a pregnancy were examined in the second trimester and their pregnancy outcomes were tracked. Results After ultrasound screening in early pregnancy,62 of the 2000 pregnant women were selected for termination of pregnancy due to their more severe deformity.In the screening group,80 twin pregnant women had no abnormalities in the results of the examination.In 2000 pregnant women,137 cases of abnormal fetuses were found by ultrasound in early pregnancy,and the abnormal detection rate was 6.85%.Of the 137 abnormal fetuses,62(45.26%) of the severe fetal malformations terminated the pregnancy.In 1938 consecutive pregnant women,94(4.85%) fetal abnormalities were found in ultrasound examination of the second trimester,including 24 cases of cardiac malformations,18 cases of urinary malformations,14 cases of facial deformities,13 cases of central nervous system malformations,11 cases of limb malformations and 14 cases of other deformities. Conclusion Ultrasound examination in early pregnancy has a significant screening effect on early-onset and severely abnormal fetuses and it has high clinical values.However,pregnancy ultrasound in early pregnancy can't replace ultrasound diagnosis in the second trimester.
引文
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[3]吕晓艳,王琳,江活永,等.经阴道和腹部联合彩色多普勒超声对胎儿先天性心脏畸形的诊断价值[J].中国预防医学杂志,2017,14(3):29-31.
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[5]王海玉.二维超声联合四维超声对不同孕周胎儿畸形诊断的价值分析[J].中国计划生育学杂志,2015,23(1):38-40.
[6]谢英俊,方群,吴坚柱,等.胎儿多发畸形与染色体异常的相关性分析[J].中山大学学报(医学科学版),2011,32(2):232-236.
[7]Bronshtein M,Solt I,Blumenfeld Z.The advantages of early midtrimester targeted fetal systematic organ screening for the detection of fetal anomalies--will a global change start in Israel?[J].Harefuah,2014,153(6):320-324,368.
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[9]林莲恩,李雪芹,谭玲,等.早孕期规范化超声检查在诊断胎儿畸形中的应用价值[J].中国妇幼保健,2014,29(31):5163-5164.
[10]缪斌.彩色多普勒超声筛查不同孕周胎儿畸形的临床研究[J].实用医技杂志,2016,23(5):503-504.
[11]郭佳,张志坤.彩色多普勒超声诊断单脐动脉与胎儿畸形相关性的研究[J].中国妇幼保健,2012,27(24):3823-3824.
[12]陶国伟,冯德朝,展新风,等.超声联合MRI技术在诊断胎儿中枢神经系统畸形中的价值[J].中华妇产科杂志,2012,47(4):299-300.
[13]卢薇薇.早孕期规范化超声检查在胎儿畸形筛查中的应用效果观察[J].中国实用医刊,2017,44(10):105-107.
[14]Jicinska H,Vlasin P,Jicinsky M,et al.Does firsttrimester screening modify the natural history of congenital heart disease?Analysis of outcome of regional cardiac screening at 2 different time periods[J].Circulation,2017,135(11):1045-1055.
[15]袁雪英,曹炎,赖育美.早孕期NT超声检查在胎儿畸形筛查中的临床应用价值探究[J].中国医学创新,2017,14(12):134-137.
[16]粱柏松,李振华,刘玲,等.不同超声扫查方法对孕早期胎儿肢体畸形的诊断作用[J].江苏医药,2012,38(12):1470-1471.
[2]李威,贾淑文,吕祥.产前超声检查对胎儿畸形的诊断价值[J].中国妇幼保健,2013,28(8):1290-1292.
[3]吕晓艳,王琳,江活永,等.经阴道和腹部联合彩色多普勒超声对胎儿先天性心脏畸形的诊断价值[J].中国预防医学杂志,2017,14(3):29-31.
[4]张铁娟,吴青青,王莉,等.产前彩色多普勒超声诊断胎儿单脐动脉及持续性右脐静脉合并胎儿相关畸形的对比研究[J].中国优生与遗传杂志,2015,27(1):100-101.
[5]王海玉.二维超声联合四维超声对不同孕周胎儿畸形诊断的价值分析[J].中国计划生育学杂志,2015,23(1):38-40.
[6]谢英俊,方群,吴坚柱,等.胎儿多发畸形与染色体异常的相关性分析[J].中山大学学报(医学科学版),2011,32(2):232-236.
[7]Bronshtein M,Solt I,Blumenfeld Z.The advantages of early midtrimester targeted fetal systematic organ screening for the detection of fetal anomalies--will a global change start in Israel?[J].Harefuah,2014,153(6):320-324,368.
[8]王宏宇,王晨虹,胡端林.吸烟孕妇的胎儿CYP1A1、GST基因多态性与胎儿先天性畸形易感性的关系[J].中国妇幼保健,2014,29(8):1232-1235.
[9]林莲恩,李雪芹,谭玲,等.早孕期规范化超声检查在诊断胎儿畸形中的应用价值[J].中国妇幼保健,2014,29(31):5163-5164.
[10]缪斌.彩色多普勒超声筛查不同孕周胎儿畸形的临床研究[J].实用医技杂志,2016,23(5):503-504.
[11]郭佳,张志坤.彩色多普勒超声诊断单脐动脉与胎儿畸形相关性的研究[J].中国妇幼保健,2012,27(24):3823-3824.
[12]陶国伟,冯德朝,展新风,等.超声联合MRI技术在诊断胎儿中枢神经系统畸形中的价值[J].中华妇产科杂志,2012,47(4):299-300.
[13]卢薇薇.早孕期规范化超声检查在胎儿畸形筛查中的应用效果观察[J].中国实用医刊,2017,44(10):105-107.
[14]Jicinska H,Vlasin P,Jicinsky M,et al.Does firsttrimester screening modify the natural history of congenital heart disease?Analysis of outcome of regional cardiac screening at 2 different time periods[J].Circulation,2017,135(11):1045-1055.
[15]袁雪英,曹炎,赖育美.早孕期NT超声检查在胎儿畸形筛查中的临床应用价值探究[J].中国医学创新,2017,14(12):134-137.
[16]粱柏松,李振华,刘玲,等.不同超声扫查方法对孕早期胎儿肢体畸形的诊断作用[J].江苏医药,2012,38(12):1470-1471.