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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2016, Vol. 13 ›› Issue (08) : 598 -602. doi: 10.3877/cma.j.issn.1672-6448.2016.08.009

所属专题： 妇产科超声影像学； 文献； 妇产科超声；

妇产科超声影像学

单脐动脉胎儿伴发先天异常的产前超声诊断分析
钟惟娜1, 邓学东1,†(), 殷林亮1   
  1. 1. 215002　南京医科大学附属苏州医院　苏州市立医院本部超声中心
  • 收稿日期:2016-04-22 出版日期:2016-08-01
  • 通信作者: 邓学东

Prenatal diagnosis of single umbilical by ultrasound: emphasis on the absent side and its relation to associated anomalies

Weina Zhong1, Xuedong Deng1,†(), Linliang Yin1   

  1. 1. Center of Medical Ultrasound, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
  • Received:2016-04-22 Published:2016-08-01
  • Corresponding author: Xuedong Deng
  • About author:
    Corresponding author: Deng Xuedong, Email:
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钟惟娜, 邓学东, 殷林亮. 单脐动脉胎儿伴发先天异常的产前超声诊断分析[J]. 中华医学超声杂志（电子版）, 2016, 13(08): 598-602.

Weina Zhong, Xuedong Deng, Linliang Yin. Prenatal diagnosis of single umbilical by ultrasound: emphasis on the absent side and its relation to associated anomalies[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(08): 598-602.

目的

探讨胎儿单脐动脉产前超声表现及伴发先天异常的临床意义。

方法

对2014年10月至2015年12月在南京医科大学附属苏州医院产前检查发现单脐动脉的121例胎儿的超声表现、合并其他异常及脐动脉缺失的侧别进行分析。

结果

单脐动脉胎儿超声特征：（1）121例单脐动脉胎儿产前二维超声横断面扫查时膀胱周围左侧或右侧仅见1条脐动脉。（2）胎儿单脐动脉检出结果：121例单脐动脉胎儿中左侧脐动脉缺失59例（48.8%，59/121），右侧脐动脉缺失62例（51.2%，62/121），左侧与右侧单脐动脉的检出率相近。（3）合并先天异常：121例单脐动脉胎儿中合并其他先天异常16例，以心脏异常占多数（43.8%，7/16），包括室间隔缺损，法洛四联症，永存左上腔静脉，主动脉弓发育不良，右位主动脉弓，右心房、右心室增大。其中右侧脐动脉缺失胎儿合并其他先天异常的检出率（68.8%，11/16）高于左侧脐动脉缺失的胎儿（31.3%，5/16）。

结论

单脐动脉胎儿左侧与右侧脐动脉缺失的检出率相近，但右侧脐动脉缺失合并先天异常的胎儿多于左侧脐动脉缺失的胎儿。

关键词: 超声检查，产前, 胎儿, 单脐动脉
Objective

To discuss the absent side of a single umbilical artery (SUA) and the clinical significance of the associated anomalies which related to it.

Methods

The characteristics of the Prenatal ultrasound findings and the associated anomalies of 121 SUA fetuses which were all examined prospectively in Prental Ultrasound Center of Suzhou Municipal Hospital from October 2014 to December 2015 were studied and analyzed.

Results

The ultrasonic features of SUA: (1) One hundred and twenty-one fetuses with SUA were diagnosed prenatally by ultrasound. There was only one umbilical artery surrounding the urinary bladder through transverse section by two-dimensional ultrasound. (2) The results of the findings of the left-absent umbilical artery and the right-absent umbilical artery: the left-absent umbilical artery was detected in 59/121 (48.8%, 59/121) fetuses, compared with right-absent umbilical artery in 62/121 (51.2%, 62/121) cases. (3) Associated with congenital anomalies: congenital anomalies were noted prenatally in 16/121 SUA fetuses and the most common abnormality was heart defects. These heart defects include ventricular septal defect, tetralogy of Fallot, persistent left superior vena cave, right-sided aortic arch, aortic dysplasia, enlarged right atrium and ventricle. Congenital anomalies were noted prenatally in 5/59 fetuses with left-absent umbilical artery and in 11/62 fetuses with right-absent umbilical artery.

Conclusions

In SUA fetuses, the absence of umbilical artery appears to occur equally at each side. Moreover, the relevance ratio of the right-absent umbilical artery with congenital anomalies is higher than that of the left-absent umbilical artery with congenital anomalies.

Key words: Ultrasonography, prenatal, Fetus, Single umbilical artery
图6 孕22周单脐动脉胎儿右侧脐动脉缺失合并鼻骨缺如
表1 16例单脐动脉胎儿合并其他先天异常产前超声表现
单脐动脉缺失侧别 例数 母亲年龄（岁） 胎儿孕龄（周） 伴发其他异常
左侧 5 26~40 18~27 半叶全前脑，唇腭裂，Dandy-Walker变异，左足内翻，双肾积水，室间隔缺损，右位主动脉弓，双上肢发育异常，多囊性肾发育不良，颈项透明层增厚
右侧 11 23~40 18~32 骶尾部椎弓根骨化不全，闭合性脊柱裂，法洛四联症，唇腭裂，VACTERL综合征，主动脉弓发育不良，脑积水，永存左上腔静脉，双胎输血综合征，双上肢异常，鼻骨缺失，腹腔混合性包块，右心房、右心室增大，盆腔马蹄肾
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