The Diagnostic Value Of Ultrasound Screening For Fetal Abnormality In Pregnancy 11-13⁺⁶ Weeks

Objective:To analyze the implication of ultrasound screening for chromosomal abnormalities and structural abnormalities in the first trimester,further to explore the diagnostic value of ultrasound screening for fetal abnormalities by 11-13⁺⁶weeks.Methods:Choose the fetus whose gestational age at 11-13⁺⁶ weeks,CRL in 45-84mm,experienced NT ultrasound screening from January 2015 to July 2017 in our hospital ultrasound department in the first trimester as the research object.It is suggested that the fetal structure and aneuploidy chromosome abnormality may be found in the first trimester,and it is suggested that the fetal chromosomes be examined and the final outcome of the fetus is obtained.The diagnostic value of ultrasonic screening of fetal abnormalities during the first trimester was determined by ultrasound examination in the system and late pregnancy.Results:A total of 2501 pregnant women who met the requirements of gestational age were enrolled in the NT examination.402 cases were lost to visit,12 cases were terminated or stopped,and 2087 cases（2121 fetuses,34 twins）were included in the study.First trimester tips abnormity in 68 cases,including 56 cases of suspected aneuploidy(56/68,positive rate was 39.29%,including NT thickening in 31 cases（31/56）,3 cases with unclear nasal display（3/56）,1 cases of single umbilical artery（1/56）,ductus venosus A wave reverse 2 cases（2/56）,4 cases of NT thickening with nasal bone unclear（4/56）,NT thickening and ductus venosus A wave reverse 3 cases（3/56）,NT thickening combined with skin edema（5 cases（5/56））,5 cases of NT thickening and structural malformation,2 cases of incomplete display of nasal bone with structural malformation,The positive rate of single soft index was 16.22%,while the positive rate of multiple soft indexes was 75.00%,and the positive rate was 100%when the soft index combined with abnormal structure.36 cases of first trimester have not been abnormal,but the middle and late pregnancy and postnatal follow-up are abnormal.The sensitivity of ultrasound screening was 47.82%,the specificity was 98.24%,the positive likelihood ratio was27.26,the negative likelihood ratio was 0.53,and the Youden index（γ）46.06%.Conclusion:Pregnancy 11-13⁺⁶weeks ultrasound screening is of great significance for fetal major structural malformation and chromosomal abnormalities.The positive rate of combined diagnosis of multiple soft indexes has been improved.However,there are some limitations in the first trimester examination,which are limited by fetal growth leve and other factors.The ultrasonic examination of second and third trimester can be supplemented.