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目的:通过对单脐动脉胎儿染色体的调查,评价单脐动脉胎儿产前诊断的价值。方法:分析2008年3月～2012年2月郑州大学第三附属医院401例单脐动脉胎儿染色体情况并与同期超声检查发现胎儿畸形及超声软指标异常行羊水穿刺染色体检查203例(对照组)比较。结果:单脐动脉合并胎儿畸形病例183例,染色体异常49例;单脐动脉合并超声软指标异常81例,染色体异常9例;染色体异常病例明显多于对照组,差异有统计学意义(P<0.05)。结论:产前诊断能准确诊断单脐动脉胎儿染色体异常,发现单脐动脉应排除胎儿畸形;单脐动脉合并超声软指标异常或胎儿畸形,应建议行产前诊断排除染色体疾病。单纯性单脐动脉是否常规行产前诊断尚需结合患者的年龄、既往生育史、家族史及患者的主观意愿综合考虑。
Objective: To evaluate the prenatal diagnosis of unilateral umbilical artery fetus by the investigation of fetal umbilical cord chromosomes. Methods: From March 2008 to February 2012, 401 cases of unilateral umbilical artery fetuses in the Third Affiliated Hospital of Zhengzhou University were analyzed. In the same period, 203 cases of fetus malformations and abnormal ultrasound soft indexes were detected by amniocentesis (control group) Compare Results: There were 183 cases of single umbilical artery with fetal malformations and 49 cases of chromosomal abnormalities. Among them, there were 81 cases of single-umbilical artery with abnormal ultrasound soft indexes and 9 cases of chromosomal abnormalities. The cases of chromosomal abnormalities were significantly more than those of control group (P < 0.05). Conclusion: Prenatal diagnosis can accurately diagnose unilateral umbilical artery fetal chromosomal abnormalities and found that single umbilical artery should be ruled out fetal malformations; single umbilical artery with ultrasound soft index abnormalities or fetal malformations, prenatal diagnosis should be recommended to rule out chromosomal disorders. Simple unilateral umbilical artery routine prenatal diagnosis still need to be combined with the patient’s age, previous fertility history, family history and the patient’s subjective wish comprehensive consideration.