论文部分内容阅读
目的:评估早孕期超声结构检查在胎儿神经管畸形诊断中的临床应用价值。方法 :回顾分析2014年6月至2015年2月在东莞市妇幼保健院产检及分娩的6 630例病例,孕11~13+6周进行胎儿超声结构检查,追踪早孕期胎儿神经管畸形引产病理结果,随访继续妊娠病例孕中期超声情况和临床结局。统计各畸形检出率,比较早中孕两个时期神经管畸形的检出类别差异。结果:各种神经管畸形早孕期检出率:露脑、无脑畸形100%(13/13),全前脑80%(4/5,无叶全前脑100%,4/4),脊柱裂42.9%(3/7,开放性脊柱裂50%,2/4),脑脊膜膨出100%(2/2)。需到中晚孕期检出的畸形包括:胼胝体缺失、Dandy-Walker综合征、叶状全前脑、侧脑室扩张。4例神经管畸形胎儿检测出染色体异常。结论:早孕期超声结构检查对胎儿严重开放性神经管畸形有较高检出率,值得临床推广,部分畸形需至中晚孕期超声检出。部分神经管畸形与染色体异常关联。
Objective: To evaluate the clinical value of ultrasonic structural examination in early pregnancy in the diagnosis of fetal neural tube defects. Methods: A retrospective analysis of 6 630 cases of childbirth and childbirth in Dongguan Maternal and Child Health Hospital from June 2014 to February 2015 was performed. Ultrastructural examination of fetuses during 11 ~ 13 + 6 weeks of gestation was performed to track the incidence of fetal neural tube defects in early pregnancy Results, Follow-up of pregnant women in the second trimester ultrasound and clinical outcomes. Statistics of the detection rate of each deformity, compared early detection of neural tube defects in early pregnancy two types of detection differences. Results: The detection rate of various neural tube defects in the first trimester was 100% (13/13) for dew, anencephaly, 80% for the whole forebrain (4/5, 100% for the non-leaf whole forebrain, 4/4) Spina bifida 42.9% (3/7, open spina bifida 50%, 2/4), meningeal bulging 100% (2/2). Defects to be detected in the second trimester of pregnancy include: corpus callosum loss, Dandy-Walker syndrome, phyllodes forebrain, lateral ventricle dilatation. 4 cases of neural tube defects fetus detected chromosomal abnormalities. Conclusion: Ultrasound examination in early pregnancy has a high detection rate of fetal open neural tube defects. It deserves clinical promotion. Some deformities need to be detected by ultrasound in middle and late pregnancy. Some neural tube defects and chromosomal abnormalities.