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目的探讨中国医师协会超声医师分会公布的“产前超声检查指南”系统产前超声检查(Ⅲ级)胎儿畸形的应用价值,以此提高产前胎儿畸形的检出率。方法 2012年10月至2014年2月间在我院接受胎儿系统检查的单胎孕妇521例。以“产前超声检查指南”为检查标准对胎儿进行系统超声检查:⑴对确诊的6大致死性胎儿畸形(产前诊断技术管理办法公布的无脑儿、脑膨出、开放性脊柱裂、胸腹壁缺损内脏外翻、单腔心及致死性软骨发育不全)建议临床终止妊娠;⑵对6大畸形以外的胎儿畸形进行跟踪随访;⑶对疑有染色体异常或难以确定的胎儿畸形病例进行转诊。结果 521例单胎孕妇中检出致死性畸形5例(无脑儿1例,脑膨出2例,腹裂内脏外翻1例,单心室1例),唇裂2例,唇腭裂1例,一侧肾积水2例,孤立性肾缺如1例,膈疝2例,肺囊腺瘤2例,单脐动脉2例,十二指肠闭锁2例,共计19例,其中漏诊和误诊各1例。结论 “产前超声检查指南”临床应用,易于操作,遵循规范系统超声检查有利于提高胎儿畸形的检出率,避免漏诊率。
Objective To investigate the value of prenatal ultrasound examination (Ⅲ grade) fetal malformations promulgated by the Ultrasound Physician Branch of Chinese Medical Association to improve the detection rate of prenatal fetal malformations. Methods A total of 521 singleton pregnant women undergoing fetal system examination in our hospital from October 2012 to February 2014 were enrolled in this study. To “prenatal ultrasound guide” for the examination of the fetus for systematic ultrasound: â ’â’ 6 deadly fetal malformations diagnosed (prenatal diagnostic techniques for management of brain anencephaly, encephalocele, open spine Fissure, thoracolumbar wall defects visceral valgus, single-chamber heart and fatal achondroplasia) recommended clinical termination of pregnancy; ⑵ 6 abnormal fetal malformations were followed up; ⑶ suspected chromosomal abnormalities or difficult to determine fetal malformations Referral. Results Among the 521 singleton pregnant women, 5 cases were fatal malformations (1 anencephaly, 2 cases encephalocele, 1 case visceral eversion and 1 case single heart ventricle), 2 cleft lip, 1 cleft lip and palate, Hydronephrosis on one side in 2 cases, solitary kidney deficiency in 1 case, diaphragmatic hernia in 2 cases, pulmonary cystadenoma in 2 cases, single umbilical artery in 2 cases, duodenal atresia in 2 cases, a total of 19 cases, including misdiagnosis and misdiagnosis 1 case. Conclusion “Prenatal ultrasound guide ” clinical application, easy to operate, follow the standard ultrasound system is conducive to improve the detection rate of fetal malformations, to avoid misdiagnosis.