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目的分析超声检查胎儿肢体畸形的漏诊原因,旨在提高超声诊断准确率,降低漏诊率。方法2004年1月-2013年12月采用常规检查方法和连续顺序追踪法对30508例孕妇进行检查。结果产后证实63例为胎儿肢体畸形,其中2004年1月-2007年12月采用常规检查方法共检出18例,漏诊10例,漏诊率35.7%,漏诊多为胎儿复杂性畸形中的较大肢体畸形;2008年1月-2013年12月采用连续顺序追踪法共检出27例,漏诊8例,漏诊率22.9%,漏诊全部为指趾骨末端畸形。结论采用连续顺序追踪法可进一步提高超声筛查胎儿肢体畸形的检出率,最大程度减少不必要漏诊。
Objective To analyze the cause of missed diagnosis of fetal limb deformity by ultrasound, aiming to improve the accuracy of ultrasonic diagnosis and reduce the rate of misdiagnosis. Methods From January 2004 to December 2013, 30,508 pregnant women were examined by routine examination and continuous sequential tracing. Results 63 postpartum cases of fetal limb deformity were confirmed. Among them, 18 cases were detected by routine examination between January 2004 and December 2007, 10 cases were missed and the rate of misdiagnosis was 35.7%. Misdiagnosis was mostly found in fetal complex deformity Limb deformity; From January 2008 to December 2013,27 cases were detected by continuous sequential tracing method, 8 cases were missed, the rate of misdiagnosis was 22.9%. All the misdiagnoses were terminal deformity of phalanges. Conclusion Continuous sequential tracing method can further improve the detection rate of fetus limb deformity by ultrasound and minimize the unnecessary missed diagnosis.