产前超声诊断不对称性联体双胎与尸检对照研究

发布时间：2018-01-04 00:16

  本文关键词：产前超声诊断不对称性联体双胎与尸检对照研究　出处：《中华医学超声杂志(电子版)》2016年09期 　论文类型：期刊论文

  更多相关文章： 超声检查 产前 联体双胎畸形 病理学

【摘要】：目的总结不对称性联体双胎产前超声表现并与产后病理尸检结果对照分析。方法对2003年1月至2016年1月湖北省妇幼保健院产前超声及病理尸检确诊的4例不对称性联体双胎超声声像图及尸检结果进行对照研究。结果产前超声显示4例不对称性联体双胎中3例寄生胎均可显示双小上肢,其中2例可显示从主胎胸腹部延伸出的双小下肢及臀部,未见肢体自主活动;产前超声漏诊1例寄生胎(未检出寄生胎的小肢体而漏诊)。4例不对称性联体双胎中2例主胎合并脐膨出,3例心脏畸形和脊柱畸形,2例膀胱外翻,2例颜面部畸形,3例羊水多。与引产胎儿检查结果对照显示,4例产前超声诊断主胎合并畸形均与引产后X线及尸检结果相符合,4例寄生胎均有小的臀部、双小上肢及双小下肢。引产胎儿标本X线摄片均可清晰显示寄生胎肢体及骨骼多发畸形、产前超声仅漏诊1例寄生胎。结论不对称性联体双胎常合并全身多发畸形,产前超声发现寄生胎及其多余的肢体是诊断不对称性联体双胎的重要线索。超声与X线检查及胎儿尸检是发现不对称性联体双胎所有畸形并最终确诊的重要检查方法。
[Abstract]:Objective to summarize the antepartum ultrasonographic findings of asymmetrical conjoined twins and to compare the results with postpartum pathological autopsy. Methods from January 2003 to January 2016, the diagnosis of prenatal ultrasound and pathological autopsy in Hubei Maternal and Child Health Hospital was confirmed. Four cases of asymmetrical conjoined twins were studied by ultrasonography and autopsy. Results 3 of 4 cases of asymmetrical conjoined twins were detected by prenatal sonography, and 3 cases of parasitic fetuses showed double small upper limbs. In 2 cases, both small lower limbs and buttocks extending from the chest and ventral part of the main fetus were shown, and no spontaneous movement of the limbs was observed. Antepartum ultrasound missed the diagnosis of one parasitic fetus (no limb of the parasitic fetus and missed diagnosis of 4 cases of asymmetrical conjoined twins) 2 cases of main fetus with umbilical exophthalmos 3 cases of cardiac malformation and 2 cases of spinal deformity of bladder valgus. There were 3 cases of amniotic fluid in 2 cases of facial malformation and 3 cases of amniotic fluid. The results of fetal examination showed that 4 cases of main fetus complicated with malformation diagnosed by prenatal ultrasound were consistent with the results of X ray and autopsy after induced labor in 4 cases of parasitic fetus with small buttocks. Both small upper limbs and both small lower extremities. X ray films of fetal specimens of induced labor can clearly show multiple deformities of parasitic fetal limbs and bones. Only one parasitic fetus was missed by prenatal ultrasound. Conclusion asymmetrical conjoined twins are often associated with multiple malformations throughout the body. Prenatal ultrasound detection of parasitic twins and their excess limbs is an important clue for the diagnosis of asymmetrical conjoined twins. Ultrasound and X-ray examination and fetal autopsy are important examinations for the detection of all malformations and final diagnosis of asymmetrical conjoined twins. Methods.
【作者单位】： 湖北省妇幼保健院超声诊断科;湖北省黄石市妇幼保健院功能科;
【基金】：湖北省自然科学基金项目(2014CFB210)
【分类号】：R445.1;D919.4
【正文快照】： 联体双胎是一种罕见的先天畸形,是由于胚盘在受精13 d后发生的分离不全所致[1]。近年国内报道的联体双胎发生率为0.001%~0.002%[2],国外报道发生率为0.0019%[3]。联体双胎畸形分为对称性和不对称性两大类[4],对称性联体双胎是指两个发育接近正常的胎儿胸腹等部分相连,不对称性，

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