产前彩超筛查单脐动脉合并胎儿畸形的诊断意义分析

摘要

目的 探讨产前彩超筛查单脐动脉(SUA)合并胎儿畸形的临床意义.方法 选取2014年1月至2016年10月在上海市嘉定区妇幼保健院进行彩色超声筛查的28 011例,筛查出98例SUA病例作为病例组,同期选择98例正常产检的孕妇作为对照组,比较两组胎儿的畸形发生率、脐动脉血流、妊娠结局等.结果 SUA的发生率为0.35%(98/28 011),SUA组的胎儿畸形发生率为24.49%(24/98),明显高于对照组的1.02%(1/98)(χ2=24.25,P=0.00),SUA组的脐动脉搏动指数(PI)、阻力指数(RI)及收缩期峰值流速与舒张末期流速比值(S/D)均明显大于对照组(t值分别为7.25、5.67、13.28,均P=0.00).SUA组的不良妊娠结局为16.33%(16/98),明显高于对照组的0.00%(P=0.00).结论 彩超对SUA和脐动脉血流动力学状况具有较好的诊断价值,而且彩超能在中孕期对SUA合并畸形进行有效筛查,对降低出生缺陷和围产儿病死率提供技术支持.%Objective To explore the clinical value of prenatal color Doppler ultrasound in screening single umbilical artery (SUA) complicating fetal anomaly.Methods Color Doppler ultrasound screening was implemented on 28 011 pregnant women, among which 98 cases of SUA were detected and recruited in case group, and 98 cases of normal pregnant women were chosen in the same period in control group.Incidence rate of fetal anomaly, umbilical artery blood flow and pregnancy outcomes were compared between two groups.Results Incidence rate of SUA was 0.35% (98/28 011).Fetal anomaly rate in SUA group was 24.49% (24/98), which was much higher than that (1.02%, 1/98) in the control group (χ2=24.25, P=0.00).Umbilical artery pulsatile index (PI), resistance index (RI) and ratio of peak systolic velocity and end diastolic velocity (S/D) in SUA group were significantly higher than those in the control group (t value was 7.25, 5.67 and 13.28, respectively, all P=0.00).Incidence of adverse pregnancy outcome in SUA group was 16.33% (16/98), which was obviously higher than that (0.00%) in the control group (P=0.00).Conclusion There is good diagnostic value of color Doppler ultrasound in screening SUA and hemodynamics of umbilical artery.Furthermore, it can effectively screen SUA complicating fetal anomaly in second trimester, and provide technique support for cutting down birth defects and perinatal mortality.