体外受精-胚胎移植胎儿心外畸形的产前超声表现及分类特征

摘要

Objective To evaluate the ultrasonographic manifestations and classification features of extracar-diac anomaly for in vitro fertilization-embryo transfer (IVF-ET) fetuses. Methods Routine prenatal ultrasound screening was performed on 1 022 pregnant women during 18~24 gestational weeks from Jan. 2010 to Sep. 2013. The ultrasound image features and classification features of extracardiac anomaly for IVF-ET fetuses were analyzed. The pregnant process and clinical outcome of pregnancy were tracked. Results Among the 1 022 fetuses, there were 879 cases of single pregnancy and 143 cases of gemellary pregnancy. Among the 1 165 fetus obtained prenatal ultrasound screening, there were 14 cases of fetal malformations (1.2%, 14/1 165), including 3 cases of facial deformity (3 cases of cheilopalatognathus, including one case of esophageal atresia), 3 cases of urinary system abnormalities (1 case of hydronephrosis, 1 case of double renal pelvisin, 1 case of lack of right kidney with left renal dysplasia), 3 cases of tho-racic deformity (1 case of pleural effusion, 2 cases of diaphragmatic hernia), 2 cases of digestive system abnormalities (1 case of persistent right umbilical vein, 1 case of esophageal atresia), 1 case of nervous system malformation (moder-ate hydrocephalus), 1 case of lymphatic system abnormity (cystic hygroma of the neck), 1 case of skeletal system de-formity (clubfoot deformity), and 1 case of twins transfusion syndrome. Conclusion Prenatal ultrasonography can give a systematic and comprehensive evaluation of fetal extracardiac anomaly in IVF-ET pregnancy and provide im-portant evidence for fetal birth defects.%目的：探讨体外受精-胚胎移植(IVF-ET)的妊娠胎儿心外畸形的超声声像图表现及分类特征。方法选取2010年1月至2013年9月在南京军区福州总医院行产前系统超声检查的IVF-ET妊娠孕妇1022例，分析IVF-ET妊娠胎儿心外畸形的超声表现及分类特征，并追踪所有孕妇的妊娠过程及临床结局。结果1022例接受IVF-ET的孕妇中单胎妊娠879例、双胎妊娠143例，共检测胎儿1165例，产前检出胎儿各种心外畸形14例(1.2%，14/1165)。其中颜面部畸形3例(唇腭裂3例，其中1例合并食道闭锁)，泌尿系统畸形3例(肾积水1例、双肾盂1例、一侧肾缺如伴另一侧异位肾1例)，胸腔畸形3例(胸腔积液1例、膈疝2例)，消化系统畸形2例(永久性右脐静脉1例、食道闭锁1例)，神经系统畸形1例(脑积水)，淋巴系统发育异常1例(颈部水囊状淋巴管瘤)、骨骼系统畸形1例(足内翻)、双胎输血综合征1例。结论产前系统超声检查能全面系统评价IVF-ET妊娠胎儿心外畸形的情况，为客观评价IVF-ET胎儿出生缺陷提供重要依据。