妊娠中期产前超声检查检测胎儿先天性异常的有效性初步研究

Madan Thapa, Shyam Sundar Parajuly, R. Adhikari, M. Shrestha
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摘要

目的:妊娠中期异常扫描提供胎儿详细解剖研究。产前发现的任何结构或形态缺陷都可以指导父母和医生进行进一步的咨询。本研究的主要目的是在18-22周发现高危患者的胎儿先天性异常,并强调产前超声检查的有效性。材料和方法:这是一项基于医院的描述性研究,于2017年1月至2019年1月在尼泊尔博卡拉卫生科学院超声科放射科完成。在产前检查(ANC)期间由产科医生通过询问患者病史或母亲年龄或在该时间段(18-22周)内的任何症状或异常或高风险患者的可能性进行首次检查和评估的孕妇被纳入研究。填写同意书时记录产妇年龄、胎次、既往异常史、流产/宫内胎儿死亡(IUFD)史或任何辐射或药物暴露史、其他疾病史。高危患者由产科医生确定,并在妊娠中期(18-20周)进行异常检查。描述性分析采用SPSS 20进行。结果:同期有224例胎儿畸形(定向胎儿解剖)患者转诊至妇产科进行“异常扫描”。其中14例在扫描期间(18-22周)发现异常。其中,中枢神经系统相关异常7例,骨骼畸形(发育不良)2例,尿路相关异常2例,肺相关异常1例,单脐动脉合并羊水过多合并十二指肠闭锁1例,淋巴系统畸形(囊性水瘤)1例。我们的研究表明,在妊娠18-22周期间进行超声扫描对诊断高危患者的主要胎儿异常是有效的。
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Effectiveness of Prenatal Ultrasound Examination at Second Trimester in Detecting Fetal Congenital Abnormalities-A Preliminary Study
Objective: Anomaly scan at the second trimester provides the detail anatomical study of fetus. Any structural or morphological defects detected prenatally guides the parents and doctors for further counseling. The main objective of this study was to detect the fetal congenital anomalies in high risk patients at 18-22 weeks and highlight the effectiveness of prenatal ultrasound examination. Materials and Methods: This was a hospital based descriptive study done during the period of 2017 January to 2019 January in the department of Radiology, ultrasound unit, Pokhara Academy of Health Sciences, Nepal. Pregnant women who were first examined and evaluated by the Obstetrician during the ante-natal check up (ANC) either by asking the patient history or by mother age or any symptoms or chance of being abnormalities or high risk patients during that time frame (18-22 weeks) were enrolled for the study. Maternal age, parity, any history of previous anomalies, previous history of miscarriage/Intra Uterine Fetal Demise ( IUFD) or any exposure to radiation or drugs, history of other disease were recorded during the filling of consent form. High risk patients were identified by the Obstetrician and anomaly examination was prescribed at second trimester (18-20 weeks). Descriptive analysis was done using SPSS 20. Results: There were two hundred and twenty four patients who had undergone anomaly (targeted fetal anatomy) examination which were referred for “anomaly scan” from the gynaecology and obstetrics department during that period. Among all the cases, fourteen cases had anomalies detected during the scan (18-22 weeks). Out of which seven cases had central nervous system related anomalies, two cases had skeletal deformities (dysplasia), two case had urinary tract related anomalies, one had lungs related anomalies and one had single umbilical artery with polyhydroamnios associated with duodenal atresia and one case had malformation of lymphatic system ( cystic hygroma ) Conclusion: Our study revealed that ultrasound scan performed between 18-22 weeks of pregnancy is effective in diagnosing major fetal abnormalities in the high-risk patients.
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