| Objective:The research is to explore the clinical value of systematic ultrasound screening for fetal deformity in first trimester through the anal ysis of the ultrasonic image characteristics of the diagnosed fetal defo rmity after induced abortion.Methods:The retrospective analysis is conducted between January,2012to February,2014in the ultrasonic departments of the third XiangYa Hospital of Central South University among1829cases of pregnant women who take the systematic ultrasound screening in the first trimester,1874cases of fetuses (including1784cases of single birth,and45cases of twins pregnancies).The pregnant women mainly comes from Hunan province, and a few of which comes from its surrounding provinces with an average age of28.2±3.1years old(rang20?42years) and an average gestational age of87.3±3.2days. Before the examination, every pregnant woman fill out a detailed questionnaire, including their parents'basic information and the personal previous medical illness, the records for this pregnancy, post childbearing history of themselves, etc.Ultrasonic suggestions show fetal structural abnormalities, and inform the parents about the prognosis, and let them make the decision of whether they will terminate the pregnancy. We take the ultrasound examination and (or) pathologic examination for the labored fetus after the consent of the pregnant women. We keep the records for each enrolled fetus of the ultrasonographic examination results, chromosome results, and the condition after birth and so on. We take the ultrasound image features of patients diagnosed with fetal structural abnormalities after abortion in its early pregnancy as an normal standard, thus to evaluate the sensibility, specificity, positive predictive value and negative predictive value of the diagnose of the fetal structural abnormalitiesResults:1874cases of fetuses among1829cases of pregnant women, which including1698cases of normal single births,86cases of single fetal abnormalities,42cases of normal twins,3cases of twins fetal abnormalities. In this series,89cases of fetal structural abnormalities were found, the incidence of which was4.75%(89/1874).35cases were diagnosed in the first trimester, and the first trimester detection rate of fetal structural abnormalities was39.3%;42cases were diagnosed in the second trimester, the detection rate of the first trimester combined with the second trimester was improved to86.5%.Therefore,45.5%(35/77) of the diagnose of fetal structural abnormalities which can only be detected in the second trimester in the past now can be diagnosed in the first trimester.Systematic ultrasonic screening for the sensibility, specificity, positive predictive value and negative predictive value of the fetal structural abnormalities in the early pregnancy were39.3%?100%?100%?97.1%respectively.Conclusion:Systematic ultrasound screening for the diagnosis the fetal structural abnormalities in the first trimester has higher diagnostic value.It implied that the fetal structural abnormalities that once diagnosed in the second trimester now can be brought forward to the first trimester.The systematic screening in the first trimester will be helpful for the pregnant woman to get an earlier decision of its pregnant outcome, thus greatly reduce the physical or mental suffering that bring to them by the termination of a pregnancy, provide proof for prenatal counseling and clinical treatment,which has very important application value and clinical significance,thus worth being popularized in clinical promotion. Figure22, table6,55references... |
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