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目的研究产前超声诊断胎儿结构异常的价值并分析漏诊原因。方法回顾性分析了1999年1月～2006年10月在我院住院分娩和引产且最终诊断有畸形的993例新生儿和引产儿的资料,以产后最终诊断为金标准评估产前超声诊断的价值。结果本组胎儿畸形发生率为22.5‰。产前超声对993例患儿(共1344处畸形)的畸形总检出率为79.02%(1062/1344);其中严重畸形检出率为87.58%(860/982),明显高于轻微畸形检出率的55.80%(202/362)(P<0.005)。各系统中,骨骼肢体系统及颜面部畸形的漏诊较多,漏诊率分别为39.46%和31.91%,漏诊畸形主要为指/趾畸形、单纯腭裂及耳畸形等。结论产前超声诊断对胎儿严重畸形的检出率高,但对于一些微小畸形及单纯腭裂等检出率低。
Objective To study the value of prenatal diagnosis of fetal structural abnormalities and analyze the causes of missed diagnosis. Methods A retrospective analysis of 993 newborns and abortion fetuses admitted to our hospital from January 1999 to October 2006 for hospitalization and induction of labor with final deformity was performed. The final diagnosis of postpartum as the gold standard for prenatal diagnosis of ultrasound value. Results The incidence of fetal malformations in this group was 22.5 ‰. The total abnormal rate of prenatal ultrasound in 993 children (1344 deformities) was 79.02% (1062/1344). The detection rate of severe deformity was 87.58% (860/982), which was significantly higher than that of mild deformity test The rate of 55.80% (202/362) (P <0.005). In each system, there were many misdiagnosis of skeletal limbs system and facial deformity, with the rate of misdiagnosis being 39.46% and 31.91% respectively. The main causes of misdiagnosis were finger / toe deformity, simple cleft palate and ear deformity. Conclusion Prenatal ultrasound diagnosis of fetal malformations of the high detection rate, but for some small deformities and simple cleft palate and other detection rate is low.