Clinical Application Of Ultrasonography In Prenatal Diagnosis Of Fetal Congenital Malformations

BackgroundFoetal growth deformities caused by one of the main causes of fetal and infant death.Congenital malformation fetus is genetic factors,the results of environmental factor and interaction of genetic and environmental factors.With the rapid development of modern medicine,fetal in utero life received more and more attention,for the protection of China's policy of eugenics,reduce birth rate of birth defects,prenatal screening of fetal malformation has become the majority of physicians must master the technical issues,because it can provide reliable first hand data for.ObjectiveThis study by Doppler ultrasound on fetal development stages comprehensive,detailed grade I,II,III level examination and understanding of fetal in morphology on whether there are abnormal development;at the same time,the detailed examination of the structure of fetal umbilical cord and umbilical cord insertion anomaly and umbilical blood flow by,records,to understand its diagnostic value in fetal malformation and its clinical significance;after the induction of fetal malformation in anatomy,provide morphological basis for prenatal diagnosis.MethodCollected in October 2013 to 2014 August in Xinxiang Medical College;the Fifth Affiliated Clinical medical cases of obstetric inpatient and outpatient department voluntary amniocentesis for abortion and termination of pregnancy the fetal malformation in 60 cases,as normal control group;and collected at the same time 80 cases of normal fetal do as the control group;the pregnant women the average gestational age(28 + 4.9)weeks,theaverage age of the women(25.5 + 5.4)years,and at the same time,the collection clinical data of all pregnant women,all cases were to follow the principle of random grouping;Determination of abnormal group and control group,the fetus,grade III ultrasonography and umbilical artery flow spectrum and the induced fetal malformation in anatomy.Result1.Abnormal group(60 cases)and normal control group of 80 cases were treated by umbilical artery blood flow monitoring,abnormal group(S / D value was significantly higher than that in normal group.In various types of deformities and S / D malformations of the central nervous system and respiratory system malformation has significant differences,and multiple malformations,digestive system abnormalities,cardiovascular malformations,malformation of the urinary system and edema fetus umbilical artery S / D value have significant difference.2.In abnormal group umbilical artery blood flow spectrum of systolic / diastolic ratio(systolic / diastolic ratio,the S / D value)was significantly higher than that of control group(P < 0.001),diastolic flow in the umbilical artery missing spectrum(absent enddiastolicflow AEDF or flip(reversed end flow,Redf)fetal occurring deformity rate is higher(75%).3.The amniotic fluid volume of the malformation complicated with fetal amniotic fluid too much or too little and the normal group had significant difference compared to,due to less than normal cases of multiple system malformation collected cases,so sheep content in single system malformations and multiple system malformation did not statistics analysis.4.Have 8 cases with single umbilical artery patients in all fetal CPC,among them 4cases complicated with fetal malformation,in 4 cases of malformations,1 case of S / D value increased,umbilical artery blood flow spectrum indicating normal,there are still possible abnormalities in the fetus;umbilical cord insertion abnormalities often affect fetal blood supply to cardiac effects on vascular system,in the development process can not ruleout vascular malformations and fetal growth restriction,we should further ultrasonography combined with obstetric biochemical examination.5.The relevant factors of congenital malformation were analyzed by logistic regression analysis.The results showed that maternal age(OR=5.223,P < 0.05),maternal occupational history(OR=5.643,P < 0.05),early pregnancy fever history(OR=3.548,P <0.05),early threatened abortion(OR=5.518,P < 0.05),adverse pregnancy history(OR=4.218,P < 0.05),and abnormal contact history(OR=4.026,P < 0.05),smoking,drinking bad habits(OR=2.875,P < 0.05),and congenital malformation related risk factors.Conclusion1.Abnormal group of pregnant women,the age slants big,suggesting that maternal age is bigger,increased probability of fetal deformities;increase the incidence of the deformity of the fetus in pregnant women with adverse pregnancy history,is related to.2.S/D value is increased in the evaluation of multiple system malformation,malformation of the urinary system,cardiovascular malformations and skin and subcutaneous tissue disease have a higher clinical value.In the exclusion of maternal factors,the umbilical artery flow velocimetry normal should be further fetal ultrasonography(grade III),combined with biochemical index to exclude fetal malformation may.3.fetal amniotic fluid volume too much or too little and there is a certain correlation between congenital malformation,abnormal amniotic fluid volume of fetal umbilical artery blood flow monitoring should be analyzed and karyotype.