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妊娠中期子宫的扩大不足,可能是胎儿异常的第一个征兆。羊水的诊断研究(核型的分析,甲胎蛋白的测定,其他生化研究)要用3～4个星期才能完成,可能赶不上人工流产可以容许的时限。而且,许多胎儿畸形与染色体或生化异常无关。因此,使用物理诊断方法可能是出生前诊断的一项有价值的辅助手段。本文报道的病例说明,放射线和超声技术配合羊膜穿刺术,可在妊娠第23周迅速而准确地诊断特异性异常,从而作出流产的决定。然后,回顾性谘询有可能确定其后妊娠时,此畸型的再现危险性。病人是初产妇,32岁,白种人,受孕前三个月一直使用口服避孕药,经期规则正常,妊娠初,孕妇有过痛性痉挛,皮肤上无斑点。
Insufficient enlargement of the uterus during the second trimester may be the first sign of fetal abnormalities. Amniotic fluid diagnostic studies (karyotype analysis, alpha fetoprotein determination, other biochemical studies) take 3 to 4 weeks to complete, may not keep up with the time allowed for abortion. Moreover, many fetal malformations have nothing to do with chromosomal or biochemical abnormalities. Therefore, the use of physical diagnostics may be a valuable adjunct to prenatal diagnosis. The cases reported in this article demonstrate that radiation and ultrasound combined with amniocentesis allow for the rapid and accurate diagnosis of specific abnormalities during the 23rd week of gestation in order to make a miscarriage decision. Then, a retrospective consultation is likely to determine the risk of subsequent reproduction of this abnormality in subsequent pregnancies. The patient is primipara, 32 years old, Caucasian, has been using oral contraceptives three months before conception, menstrual rules are normal, early pregnancy, pregnant women had painful spasms, no spots on the skin.