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目的探讨胎儿腹内段脐静脉扩张(FIUV)的超声表现及临床意义。方法回顾性分析9例经超声诊断为FIUV的声像图表现与随访结果,总结其声像图特点与妊娠结局之间的关系。结果超声诊断FIUV 9例,其中单纯性FIUV 5例,1例伴轻微结构异常,以上6例经顺产或剖腹产后均生长发育正常。3例合并其他结构严重异常,其中1例胎死宫中,2例引产(1例经羊膜腔穿刺胎儿染色体检查为21-三体)。FIUV的主要声像图表现为胎儿腹壁与肝下缘之间出现管状或囊袋状暗区,彩色多普勒显示充盈血流,频谱多普勒呈现连续的静脉频谱。结论单纯或伴轻微结构异常的FIUV,超声可定期严密监测,继续妊娠直至胎儿娩出,一般结局良好。若FIUV合并胎儿其他严重结构异常则往往预后不良。临床需及时干预,并进行染色体筛查。
Objective To investigate the ultrasonographic manifestations and clinical significance of fetal intra-abdominal umbilical vein dilatation (FIUV). Methods The clinical manifestations and follow-up results of 9 cases diagnosed as FIUV by ultrasound were retrospectively analyzed. The relationship between sonographic features and pregnancy outcome was summarized. Results Ultrasound diagnosis of FIUV in 9 cases, including simple FIUV in 5 cases, 1 case with slight structural abnormalities, more than 6 cases by birth or caesarean section growth and development were normal. Three patients with other serious structural abnormalities, including 1 case of fetal death, 2 cases of induced labor (1 case of amniocentesis by fetal chromosomal examination of 21 - trisomy). The main ultrasonography of FIUV showed a tubular or pouch-like dark area between the abdominal wall of the fetus and the lower edge of the liver. Color Doppler showed a filling of the bloodstream, and spectral Doppler presented a continuous venous spectrum. Conclusions FIUV, simple or with slight structural abnormalities, can be closely and regularly monitored by ultrasonography. Pregnancy is continued until the fetus is delivered. The general outcome is good. If FIUV combined with other serious fetal abnormalities are often poor prognosis. Clinical need timely intervention, and chromosome screening.