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目的通过超声检查早发现、早干预宫内脑积水胎儿,减少出生缺陷,提高出生人口素质。方法对怀孕>15周的孕妇,在孕16、24、32周进行超声检查观察胎儿脑发育情况,对于重度脑积水并脑发育典型异常者早期干预及时终止妊娠;对于轻度脑积水进一步经MRI检查确诊继续妊娠。结果从2368例围产保健孕妇中筛选出1118例符合条件的观察对象,共检出胎儿脑积水者34例。超声检出脑积水并脑发育畸形23例,其中15例终止妊娠,8例失去联系;11例轻度异常者生后7例发育正常,另4例中2例智力+运动发育稍落后,2例运动落后者经康复治疗达正常水平。结论孕早期发现胎儿脑积水以及脑发育异常,超声检查是最方便、适时、快捷、廉价、准确、无创的首选方法;MRI是进一步明确诊断的无创检查,典型的胎儿脑发育畸形可及时终止妊娠;仅有轻度脑积水不合并脑发育畸形者可以在严密观察中继续妊娠;出生婴儿可以正常发育,部分会有发育落后经康复治疗可达正常儿发育水平。
Objective Early detection by ultrasound, early intervention intrauterine fetal water, reduce birth defects, improve the quality of birth population. Methods Pregnant women of> 15 weeks of pregnancy were examined by ultrasound at 16, 24 and 32 weeks of gestation to observe the development of fetal brain. The early intervention of severe hydrocephalus and brain dysplasia was terminated and the pregnancy was terminated. For mild hydrocephalus Confirmed by MRI examination to continue pregnancy. Results A total of 1118 matched eligible subjects were screened from 2368 pregnant women with perinatal health care. A total of 34 cases of fetal hydrocephalus were detected. There were 23 cases of hydrocephalus and brain deformity detected by ultrasound, of which 15 cases terminated pregnancy and 8 cases lost contact with each other. Eleven patients with mild dysplasia developed normally after birth, and the other 4 patients were slightly outgrowed by mental and motor development. 2 cases of backward athletes after rehabilitation treatment up to normal levels. Conclusion Fetal hydrocephalus and abnormal brain development were found in early pregnancy. Ultrasonography was the most convenient, timely, inexpensive, accurate and noninvasive method in early pregnancy. MRI was a non-invasive examination to further confirm the diagnosis. Typical fetal brain malformations could be terminated in time Pregnancy; only mild hydrocephalus without brain deformity can continue observation in close observation of pregnancy; born infants can be normal development, in part, there will be backward development after rehabilitation up to the normal level of child development.