探讨产前超声动态监测胎儿肠管扩张的临床价值，分析其与新生儿小肠梗阻的相关性，为产前咨询、预后分析提供依据。

回顾性收集2019年1月至2025年8月在北京协和医院就诊或转诊的中晚孕期超声提示胎儿肠管宽度超过相应孕周第97百分位数值的病例，记录肠管扩张检出孕周、肠管扩张宽度、羊水量、腹腔积液等超声指标并随访生后结局，依据随访结果将新生儿分为小肠梗阻组和非肠道梗阻组。采用Fisher精确概率检验或Mann-Whitney U非参数检验比较组间各指标数据的差异。

共纳入34例肠管扩张病例，其中22例新生儿证实小肠梗阻（小肠梗阻组），12例无梗阻（非肠道梗阻组）。小肠梗阻组肠管扩张首次检出孕周更早（P=0.036）、肠管扩张宽度更宽[2.64（1.50，5.94）mm vs 1.35（0.62，2.32）mm；Z=3.127，P=0.002]，且均至少2次超声检查提示扩张。亚组分析显示，空肠闭锁病例（9例）较回肠闭锁病例（8例）更易在中孕期首次检出肠管扩张（77.8% vs 12.5%，P=0.023），且更常合并羊水过多（88.9% vs 12.5%，P=0.003）。8例合并胎粪性腹膜炎者均合并腹腔积液，其中3例出现肠管宽度一过性降低。除1例回肠闭锁患儿术后死亡外，其余患儿均预后良好。

产前超声动态监测肠管扩张变化，结合检出孕周、扩张程度、羊水量及腹腔积液等指标，可有效判断胎儿是否存在小肠梗阻及梗阻部位，并早期识别胎粪性腹膜炎等并发症，对预后评估及产前咨询具有重要临床价值。

To evaluate the clinical value of dynamic prenatal ultrasonography in monitoring fetal intestinal dilatation, and to analyze its correlation with neonatal small intestinal obstruction, so as to provide evidence for prenatal counseling and prognostic evaluation.

A retrospective analysis was conducted on cases in which fetal intestinal width exceeded the 97th percentile for the corresponding gestational week as identified by mid-to-late pregnancy ultrasonography. All case were managed or referred to Peking Union Medical College Hospital from January 2019 to August 2025. Ultrasonic parameters recorded included the gestational week at initial detection of intestinal dilatation, severity of dilatation, amniotic fluid volume, and presence of abdominal effusion. Postnatal outcomes were followed up and statistically analyzed.

A total of 34 cases with fetal intestinal dilatation were enrolled, of whom 22 were postnatally confirmed as neonatal small intestinal obstruction and 12 had no obstruction. Compared with the non-obstruction group, the obstruction group had an earlier gestational week at initial detection of intestinal dilatation (P=0.036) and more severe dilatation [2.64 (1.50, 5.94) mm vs 1.35 (0.62, 2.32) mm; Z=3.127, P=0.002]; moreover, intestinal dilatation was detected on at least two consecutive ultrasonographic examinations. Subgroup analysis showed that jejunal atresia was more likely than ileal atresia to present with intestinal dilatation in the second trimester (77.8% vs 12.5%, P=0.023), and was accompanied by a higher incidence of polyhydramnios (88.9% vs 12.5%, P=0.003). All 8 cases complicated by meconium peritonitis had abdominal effusion, and 3 of them showed a transient reduction of intestinal diameter. Except for one infant with ileal atresia who died after surgery, all other infants achieved a favorable prognosis.

Dynamic prenatal ultrasonic monitoring of fetal intestinal dilatation, combined with indicators including gestational week at detection, dilatation severity, amniotic fluid volume, and abdominal effusion, enables accurate prediction of fetal small intestinal obstruction and its location, as well as early identification of complications such as meconium peritonitis. This is of crucial clinical significance for prenatal prognosis assessment and genetic counseling.