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目的探讨影响产前超声诊断胎儿出生缺陷(胎儿先天畸形)的因素。方法对319例分娩证实的胎儿畸形与产前超声诊断结果进行对照分析。结果产前超声诊断胎儿出生缺陷240例,诊断符合率75.23%;漏误诊79例,漏误诊率24.76%。各类出生缺陷漏误诊构成比依次为心脏缺陷25.23%,多指(趾)、并(趾)指畸形15.18%,尿道下裂11.39%,唇腭裂8.86%,肢体关节畸形7.59%,足内(外)翻5.06%,隐性脊柱裂5.06%,两性畸形5.06%,染色体异常3.79%,外耳廓畸形3.79%,无眼球1.26%,双足皮肤缺损1.26%,轻度鱼鳞病1.26%,其它畸形5.06%。结论影响产前超声诊断胎儿出生缺陷的因素,主要为胎儿畸形的类别、超声医师个人专业的差异、产科医师宣教、产前超声检查的时间、次数、仪器条件、母体的情况(肥胖、水肿等)、胎儿的宫内情况(羊水、体位)以及胎儿的宫内情况和产科医师的宣教有关。
Objective To investigate the factors affecting the diagnosis of fetal birth defects (fetal congenital malformations) by prenatal ultrasound. Methods 319 cases of confirmed fetal malformations and prenatal diagnosis of ultrasound were compared. Results Prenatal ultrasound diagnosis of birth defects in 240 cases, the diagnostic coincidence rate of 75.23%; misdiagnosis in 79 cases, misdiagnosis rate of 24.76%. Misdiagnosis of birth defects of various types of misdiagnosis constitute the order of 25.23% of heart defects, finger (toe), and finger deformities 15.18%, hypospadias 11.39%, cleft lip and palate 8.86%, limb deformities 7.59%, foot ( 5.06% of the recessive spina bifida, 5.06% of the hermaphroditism, 3.79% of the chromosomal abnormalities, 3.79% of the auricle deformities, 1.26% of the non-eyeballs, 1.26% of the bipedal skin defects, 1.26% of the mild ichthyosis and other deformities 5.06%. Conclusions The factors influencing the prenatal ultrasound diagnosis of fetal birth defects are mainly the types of fetal malformations, the differences of individual physicians in ultrasound, the time and frequency of prenatal ultrasound examination, the time and frequency of prenatal ultrasound examination, the condition of the instruments, the maternal condition (obesity, edema, etc.) ), Fetal intrauterine conditions (amniotic fluid, body position) and intrauterine fetal conditions and obstetric education mission.