彩色多普勒超声诊断单脐动脉合并胎儿先天性结构畸形的价值

目的 评价彩色多普勒超声诊断单脐动脉合并胎儿先天性结构畸形的价值。方法 回顾性分析接受产前筛查的297胎单脐动脉及91胎单脐动脉合并胎儿先天性结构畸形的超声特点,对其羊水染色体检查结果进行分析,并与产后新生儿特殊检查或引产后尸体解剖及病理检查结果相对照。结果 本组43572名孕妇中,共检出单脐动脉297胎,单脐动脉的发生率为0.68%(297/43572);单脐动脉中合并胎儿先天性结构畸形91胎,发生率为30.64%(28/297);单脐动脉合并胎儿先天性结构畸形中染色体异常28胎,发生率为30.77%(91/297)。合并畸形中,居前3位者分别为心血管系统、泌尿系统、中枢神经系统畸形;单脐动脉合并多发畸形较单发畸形多见,且合并畸形种类越多,染色体异常发生率越高。结论 单脐动脉可引起较高畸形发生率。彩色多普勒超声能较准确诊断单脐动脉合并胎儿先天性结构畸形。

Value of color Doppler ultrasonography for diagnosing single umbilical artery associated with congenital structure anomalies

Objective To assess the value of color Doppler ultrasonography for diagnosing single umbilical artery (SUA) associated with congenital structure anomalies. Methods Ultrasonic findings of 297 SUA fetuses and 91 fetuses of SUA associated with congenital structure anomalies, as well as the chromosome results through amniocentesising were retrospectively analyzed and compared with the specific check-results of neonates or pathologic findings after induction. Results Totally 297 fetuses among 43572 pregnant women were diagnosed SUA, the incidence of SUA was 0.68% (297/43572). Ninety-one fetuses (91/297, 30.64%) were diagnosed SUA associated with congenital structure anomalies, of which 8 fetuses (28/297, 30.77%) with chromosome abnormalities. The first three of congenital structure anomalies included cardiovascular system anomalies, urinary system anomalies and central nervous system anomalies. SUA associated with multi-congenital structure anomalies were more than SUA associated with single-congenital structure anomalies, and the more congenital structure anomalies, the higher abnormal chromosome. Conclusion SUA may lead to high incidence of congenital structure anomalies. Color Doppler ultrsonography can accurately diagnose SUA associated with congenital structure malformations.