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目的观察和探讨胎儿四肢骨骼系统发生畸形产前超声诊断情况,针对不同孕期检出率进行比较分析,以期为临床诊断和预测胎儿肢体骨骼畸形提供客观的理论依据。方法入选于我院进行产前超声筛查的孕妇2380例作为研究观察对象,对产前超声诊断为肢体骨骼畸形的胎儿进行引产后经放射线诊断和尸检结果证实均存在肢体骨骼畸形,分析产前超声检查对胎儿肢体骨骼畸形检出情况,并针对不同孕期的诊断准确性进行对比分析。结果经筛查结果显示,2380例胎儿经孕妇产前常规超声检查出现肢体骨骼畸形28例,肢体骨骼畸形发生率为1.18%。对不同类型胎儿肢体骨骼畸形进行超声筛查结果显示,经引产或尸检证实例数为45例,其中产前超声诊断符合率为62.2%,产后证实率为37.8%;针对不同孕周胎儿肢体骨骼畸形超声筛查结果进行统计分析结果显示,孕18~24w检出率高达93.75%,孕25~32w检出率高达93.33%,其检出率明显高于孕11~17w(37.5%)及孕期>33w(50%),差异具有显著性(P﹤0.05)。结论产前超声检查诊断胎儿肢体骨骼系统发育畸形准确率较高,同时具有无创性、可重复性、安全性等优势,特别是中孕期进行超声诊断大大提高了畸形的检出率,因此在中孕期进行超声诊断是产前诊断胎儿肢体骨骼畸形的有效手段。
Objective To observe and explore the prenatal ultrasound diagnosis of fetal limbs skeletal system abnormalities, and to analyze the detection rate in different stages of pregnancy, in order to provide an objective theoretical basis for clinical diagnosis and prediction of skeletal deformities of fetal limbs. Methods A total of 2380 pregnant women selected for prenatal ultrasound screening in our hospital were selected as research objects. The fetus with prenatal ultrasound diagnosis of limb skeletal malformations was diagnosed by radiation diagnosis and postmortem examination. Ultrasound examination of fetal limb skeletal deformity detected, and for different gestational diagnostic accuracy for comparative analysis. Results The screening results showed that 2380 fetuses had 28 cases of limb skeletal deformities and the incidence of limb skeletal deformity was 1.18% by routine prenatal ultrasound examination. Ultrasound screening of skeletal deformities of different types of fetal limbs showed that 45 cases were confirmed by induced labor or autopsy, of which the coincidence rate of prenatal ultrasound was 62.2% and postpartum confirmed rate of 37.8% The result of abnormal ultrasound screening showed that the detection rate was 93.75% at 18 ~ 24 weeks and 93.33% at 25 ~ 32 weeks, the detection rate was significantly higher than that of 11 ~ 17 weeks (37.5%) and pregnancy > 33w (50%), the difference was significant (P <0.05). Conclusion Prenatal ultrasonography diagnosis of fetal limb skeletal system developmental malformations higher accuracy, at the same time with noninvasive, reproducibility, safety and other advantages, especially in the second trimester ultrasound diagnosis greatly increased the detection rate of deformity, so in Ultrasound diagnosis during pregnancy is an effective prenatal diagnosis of fetal limb skeletal deformities.