早孕期超声筛查在胎儿结构畸形诊断中的应用

目的：探究早孕期系统性超声筛查在胎儿结构畸形诊断中的临床应用价值。方法选取聊城市第二人民医院于2013年5月至2015年5月期间接受孕期超声检查的11～13＋6周孕妇64例，行早期超声胎儿筛查；对妊娠至22～24＋6周孕妇行中孕期超声检查（采用连续扫查法），并对以上最终的结果进行跟踪。结果早孕期畸形胎儿检出率与中孕期畸形胎儿检出率相比，组间无显著性差异（χ2＝1．03，P＞0．05），早中孕期联合诊断畸形胎儿检出率与单独的早孕期检出率和中孕期检出率相比，组间均存在显著性差异（χ2＝4．53，P＜0．05；χ2＝5．39，P＜0．05）。早孕期超声筛查胎儿结构畸形共36种类型，占前3位的分别为：颈部水囊瘤及NT增厚（33．33％）、颜面部异常（25．00％）、前腹壁异常（11．11％）；中孕期超声筛查胎儿结构畸形共42种类型，占前3位的分别为：心血管异常（30．95％）、颜面部异常（21．43％）、中枢神经系统异常（11．11％）。早孕期与中孕期进行系统性超声筛查结果中，各类畸形结构分布率均存在显著性差异（χ2＝4．55～6．32，P＜0．05）。结论早孕期进行系统性超声筛查，胎儿结构畸形检出率较高，但是不能完全取代中期的超声检查，同时建议早中联合检查可以提高胎儿结构畸形的检出率。

Application of early prenatal systemic ultrasound screening in diagnosis of fetal deformity

Objective To explore the clinical value of early prenatal systemic ultrasound screening in diagnosis of fetal deformity.Methods Sixty-four pregnant women who accepted prenatal ultrasound examination during 11 to 13 +6 gestational weeks in the Second People ’ s Hospital of Liaocheng City from May 2013 to May 2015 were selected to do the early prenatal ultrasound screening.Medium-term prenatal ultrasound was done among the cases of 22 -24 +6 weeks of pregnancy (continuous scan method), and the final results were tracked. Results The fetus deformity detection rates of early prenatal ultrasound screening and medium-term prenatal ultrasound in both groups were not obviously different (χ2 =1.03,P>1.03).Compared to the detection rates of single early prenatal ultrasound screening or single medium-term prenatal ultrasound, the deformity rate in the joint early prenatal ultrasound and medium-term prenatal ultrasound showed significant difference (χ2 =4.53,P<0.05; χ2 =5.39, P<0.05).There were 36 types of fetal structural deformity detected in early prenatal ultrasound.The top three were as follows: cervical cystic carcinoma and NT thickening ( 33.33%) , facial abnormality (25.00%), and anterior abdominal wall abnormality (11.11%).There were 42 types of fetal structural deformity detected in medium-term prenatal ultrasound.The top three were as follows: cardiovascular abnormalities (30.95%), facial abnormalities (21.43%), and central nervous system abnormalities (11.11%).In the results of systemic ultrasound screening in early and medium-term pregnancy, the distribution rates of all kinds of structural deformity were significantly different (χ2 value ranged 4.55 to 6.32, all P<0.05).Conclusion The detection rate of fetal structural deformity is higher in early prenatal systemic ultrasound screening which, however, cannot completely replace the medium-term ultrasound.The joint examination of early and medium-term prenatal ultrasound is suggested to improve the detection rate of fetal deformity.