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目的评价非选择孕妇11～13+6孕周和14～17+6孕周胎儿超声筛查的作用。方法 2008年2月至2011年6月广西柳州市妇幼保健院行11-17+6孕周胎儿首次产前常规超声检查共15 725例患者,其中11-13+6孕周组11 692例,14～17+6孕周组4033例。比较两组胎儿结构异常的检出率及畸形类型构成比。结果 11～13+6孕周组和14～17+6孕周组胎儿结构异常首次检出率分别为2.30%(269/11692)和1.76%(71/4033)。两组胎儿结构异常类型构成比差异。11～13+6孕周组胎儿畸形前3位为颈部异常(项颈透明层增厚及颈部淋巴水囊瘤)占26.4%(71/269),前腹壁异常占20.7%(56/269),中枢神经系统异常占11.3%(30/269)。14～17+6孕周组胎儿畸形前3位为中枢神经系统异常占36.6%(26/71),颈部淋巴水囊瘤占25.4%(18/71),水肿胎占18.3%(13/71)。结论 11～13+6孕周胎儿超声检查能诊断多种致死性胎儿畸形及检测各种染色体异常超声标记;14～17+6孕周胎儿超声检查可观察相对细微的胎儿结构异常。11～13+6孕周是早期胎儿超声筛查的理想时间。
Objective To evaluate the role of fetal ultrasound screening in 11 ~ 13 + 6 gestational weeks and 14 ~ 17 + 6 gestational weeks in non-selected pregnant women. Methods From February 2008 to June 2011, 15 725 pre-natal routine ultrasound examinations of 11-17 + 6 gestational weeks in Liuzhou Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region were performed, of which 11 692 were from 11-13 + 6 gestation weeks, 14 ~ 17 + 6 gestation group 4033 cases. The detection rate of fetal structural abnormalities and the ratio of malformation types were compared between the two groups. Results The first detection rates of fetal structural abnormalities in gestational weeks 11 ~ 13 + 6 and gestational weeks 14 ~ 17 + 6 were 2.30% (269/11692) and 1.76% (71/4033), respectively. Fetal structure abnormalities between the two types of composition ratio differences. In the 11 ~ 13 + 6 gestational age group, the first 3 fetuses had neck abnormalities (26.4% (71/269) in neck clear layer thickening and cervical lymphoepithelioma), anterior abdominal anomalies accounted for 20.7% (56 / 269), central nervous system abnormalities accounted for 11.3% (30/269). The first 3 fetuses with gestational age from 14 to 17 + 6 were 36.6% (26/71) of the central nervous system abnormalities, 25.4% (18/71) with cervical lymphoepithelioma, and 18.3% with edema (13 / 71). Conclusions Fetal sonography of 11 ~ 13 + 6 gestational weeks can diagnose a variety of fatal fetal malformations and detect various chromosomal abnormalities. Fetal ultrasound findings of 14 ~ 17 + 6 gestational weeks can observe relatively minor fetal structural abnormalities. 11 ~ 13 + 6 gestational weeks is the ideal time for early fetal ultrasound screening.