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| 产前超声对胎儿脐动脉栓塞的诊断价值 |
| 孙娟,吴青青,马玉庆,姚苓,韩吉晶,张铁娟,高凤云,郭翠霞,邓迪,王莉 |
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| (首都医科大学附属北京妇产医院) |
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| 摘要: |
| 目的:探讨产前超声诊断胎儿脐动脉栓塞的临床意义。方法:对2015年1月-2019年5月在本院超声检查发现一支脐动脉栓塞，并于本院分娩或引产共7例胎儿的超声图像及妊娠结局等进行回顾性分析。结果: 7例胎儿20-24周超声检查均为双脐动脉，均于28周后（28-30周）发现一支脐动脉栓塞，并于分娩后诊断脐动脉血栓，4例于分娩后诊断脐带过度扭转。超声表现其中4例为一支脐动脉内可见实性回声改变。1例为一支脐动脉内径减小继发脐动脉栓塞， 2例28周后超声诊断为单脐动脉，未显示脐动脉内血栓。5例活产，其中3例早产；2例胎死宫内。4例胎儿宫内生长受限，3例胎儿大小符合孕周。结论:脐动脉栓塞胎儿并发症和病死率高，严重影响胎儿预后，与不良妊娠结局密切相关，孕晚期超声检查应高度警惕有无脐动脉栓塞的发生，一经确诊，密切监测胎儿情况，及时终止妊娠，能有效地降低围产儿的死亡率并改善预后 。 |
| 关键词: 脐动脉栓塞 超声诊断? 不良妊娠结局 |
| DOI： |
| 投稿时间：2020-03-03修订日期：2021-06-13 |
| 基金项目:北京市医院管理局“登峰计划专项”，编号DFL20151302 |
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| The value of prenatal ultrasonography in the diagnosis of fetal umbilical artery embolism |
| sunjuan,wuqingqing,mayuqing,yaoling,hanjijing,zhangtiejuan,gaofengyun,guocuixia,dengdi,wangli |
| (Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital) |
| Abstract: |
| Abstract: objective: to explore the clinical significance of prenatal ultrasound in the diagnosis of fetal umbilical artery embolism. Methods: a umbilical artery embolism was found in our hospital from January 2015 to May 2019, and the ultrasonographic images and pregnancy outcomes of 7 fetuses delivered or induced in our hospital were analyzed retrospectively. Results: 7 fetuses showed double umbilical artery at 20-24 weeks. Umbilical artery embolism was found in 7 fetuses after 28 weeks (28-30 weeks). Umbilical artery thrombosis was diagnosed in all cases after delivery, and excessive torsion of umbilical cord was diagnosed in 4 cases after delivery. Among them, 4 cases showed solid echo changes in one umbilical artery. One case was secondary umbilical artery embolism with reduced internal diameter of umbilical artery, and 2 cases were diagnosed as single umbilical artery by ultrasonography after 28 weeks. There were 5 cases of live birth, 3 cases of premature delivery and 2 cases of fetal death in the uterus. There were 4 cases of intrauterine growth restriction and 3 cases of fetal size in accordance with gestational weeks. Conclusion: fetal complications and mortality of umbilical artery embolization are high, which seriously affect fetal prognosis and are closely related to adverse pregnancy outcome. Ultrasound examination in the third trimester of pregnancy should be highly alert to the occurrence of umbilical artery embolism. Once diagnosed, closely monitor the condition of the fetus. Timely termination of pregnancy can effectively reduce perinatal mortality and improve prognosis.
Key words: Umbilical artery embolism; Ultrasonic diagnosis; Adverse pregnancy outcome |
| Key words: Key words: Umbilical artery embolism Ultrasonic diagnosis Adverse pregnancy outcome |
