| 摘要: |
| 目的探讨早期超声筛查在体外受精-胚胎移植(IVF-ET)妊娠中的临床应用价值。方法对2010年1月至12月在本院生殖中心接受IVF-ET的685例孕妇于妊娠早期(11~13+6周)进行超声筛查, 内容包括胎数、多胎绒毛膜性及孕龄的确定, 胎儿早期结构异常筛查, 超声软标记(sonographic markers)检测；对异常胎儿选择性行绒毛取样或羊水穿刺术, 对确定为三胎或双胎之一致死性畸形者行减胎术；并追踪所有孕妇的妊娠过程和临床结局。结果685例受检IVF-ET孕妇中, 单胎妊娠440例, 发生率64.23%；双胎妊娠244例, 发生率35.62%；三胎妊娠1例, 发生率0.15%。单胎妊娠早期共发现7例胎儿超声异常, 临床确诊5例。双胎妊娠早期共发现6例超声异常, 临床确诊3例。除去三胎, 本组IVF-ET孕妇总的胎儿畸形发生率为0.86%(8/928), 其中2例经染色体检查确诊, 另有2例接受减胎术。结论通过对IVF-ET妊娠早期(11~13+6周)进行超声筛查, 可以提高异常胎儿早期检出率, 并对多胎及异常胎儿的早期处理有临床指导意义。 |
| 关键词: 妊娠早期 超声检查 体外受精-胚胎移植 超声软标记 胎儿畸形 |
| DOI：10.3724/SP.J.1008.2012.00514 |
| 投稿时间：2011-12-14修订日期：2012-03-07 |
| 基金项目:江苏省科技支撑计划(社会发展)(Be2009620). |
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| Clinical value of prenatal ultrasonography in diagnosis of fetal abnormalities in fertilization-embryo transfer during early trimester |
| YANG Li-juan,RU Tong﹡,GU Yan,YANG Yan,DAI Chen-yan,XU Yan,WANG Zhi-qun |
(Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical College, Nanjing 210008, Jiangsu, China
*Corresponding author.) |
| Abstract: |
| ObjectiveTo evaluate the value of prenatal ultrasonography in diagnosis of in vitro fertilization-embryo transfer (IVF-ET) fetal abnormalities during early trimester. MethodsA total of 685 IVF-ET pregnant women received Doppler color ultrasound in our hospital during 11-13+6 weeks of pregnancy from January 2010 to December 2010; the number of fetal, polyembryony chorion, and gestational age were examined; and the abnormal structures were screened. Based on findings of sonographic markers, chorionic villi sampling was done for some fetals. Amniocentesis or selective reduction was done when triplet or one of the twins found with lethal abnormality. All the cases were followed up for pregnancy process and clinical results. ResultsAmong the 685 IVF-ET pregnant women, 440 had singleton pregnancy (64.23%), 244 had twin pregnancy (35.62%), and only one had triplet pregnancy (0.15%). Seven fetal abnormalities were detected in singleton pregnancies during early trimester, and five cases were clinically confirmed. Six fetal abnormalities were detected in twin pregnancies during early trimester, and three cases were clinically confirmed. Excluding the triplet pregnancy, the total incidence rate of abnormal fetal was 0.86%(8/928), with two cases confirmed by chromosomal abnormality screening and two cases receiving selective reduction operation. ConclusionStandardized prenatal ultrasonography during early trimester(11-13+6 weeks) can improve the accurate screening rate of fetal abnormalities for IVF-ET pregnancy, and can help to deal with multiple pregnancy and abnormal fetals. |
| Key words: early trimester ultrasonography fertilization in vitro sonographic markers fetal abnormalities |
