| Objective:To explore the clinical diagnostic value of two-dimensional,four-dimensional ultrasound and combined examination of the two for fetal malformations during pregnancy and its impact on pregnancy outcomes.methods: A total of 804 mid-pregnancy pregnant women who were admitted to the hospital from March 2015 to August 2017 were selected as study subjects.All pregnant women are informed consent in this study,hospital ethics committee approval at the same time.A comprehensive two-dimensional ultrasound examination of the fetal system was performed through continuous sequential tracing to examine the fetal body and posture.The body surface and the splanchnic structure were observed.If the fetus was suspected to be deformed,it was examined again using four-dimensional ultrasound to help the patient to confirm the diagnosis;the follow-up of the suspected fetus was reinforced,and the two-dimensional ultrasound,four-dimensional ultrasound,two-dimensional and four-dimensional ultrasound examination results were combined.Comparing with the follow-up results,record and count fetal pregnancy outcomes.Results: A total of 852 fetuses were delivered to 804 mid-pregnancy pregnant women.A total of 136 malformations were detected.129 sites were identified during follow-up,including 27 facial facial deformities,5 digestive malformations,31 central nervous system malformations,and skeletal system of extremities.There were 26 malformations,11 malformations of the cardiac system,7 malformations of the urinary system,11 abnormalities of the thoracic and abdomen,and 11 abnormalities of the skin.The accuracy of the two-dimensional ultrasound diagnosis was 66.7%,and the accuracy of the four-dimensional ultrasound diagnosis was 81.40%.The accuracy of combined ultrasound diagnosis was 85.3%.The accuracy of joint diagnosis was significantly higher than that of two-dimensional ultrasound alone and four-dimensional ultrasound alone(P<0.05).The accuracy of four-dimensional ultrasound diagnosis was higher than that of two-dimensional ultrasound(P< 0.05);In the diagnosis of fetal body surface malformations,the accuracy of two-dimensional ultrasound diagnosis was 70.4%,the accuracy of four-dimensional ultrasound diagnosis was 78.87%,and the accuracy of two-dimensional and four-dimensional joint diagnosis was 84.5%.Joint diagnosis was detected.The accuracy rate was significantly higher than that of two-dimensional ultrasound diagnosis and four-dimensional ultrasound diagnosis alone(P<0.05);the accuracy of four-dimensional ultrasound diagnosis of body surface deformity was higher than that of two-dimensional ultrasound(P<0.05).Use,higher than two-dimensional ultrasound and four-dimensional ultrasound examination(P <0.05);four-dimensional ultrasound examination costs,higher than two-dimensional ultrasound(P <0.05);risk factors for fetal malformation logistic analysis results showed that age,during pregnancy medication,TORCH infection,Occupational factors,syphilis infections,and HIV infections are all important risk factors for fetal malformation,among which occupational factors,syphilis infections,and HIV infection are more risky(P<0.05);patient satisfaction is related to their medical environment,medical equipment,and health care attitudes.There was a positive correlation between medical expenses,medical treatment effect and waiting time(P<0.05).Conclusion:(1)The two-dimensional ultrasound and four-dimensional ultrasound are ideal for the diagnosis of fetal malformations in the second trimester,which can help the early diagnosis of the fetus;(2)The two-dimensional ultrasound and four-dimensional ultrasound can be used in the diagnosis of fetal malformation in the second trimester.Higher diagnostic sensitivity and specificity can help improve pregnancy outcomes;(3)There are many influencing factors in the results of two-dimensional ultrasound and four-dimensional ultrasonography.Effective,convenient,feasible,and saving medical care should be established according to risk factors.The screening system serves the people more. |
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