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目的探讨胎儿泌尿系统畸形产前超声误诊及漏诊病例特点与原因。方法分析产前漏误诊23例胎儿泌尿系统畸形病例特点及相关预后随访资料。结果产前误诊15例,包括盆腔异位肾7例(46.7%,7/15)、双肾积水4例(26.7%,4/15)、重复肾2例、婴儿型多囊肾1例和马蹄肾1例;漏诊8例,包括外生殖器畸形5例(62.5%,5/8)、输尿管囊肿1例、胸腔异位肾合并膈疝1例及膀胱外翻1例。男17例(73.9%,17/23),女4例(17.4%,4/23),性别不清2例(8.7%,2/23)。22例行产前多学科会诊,引产6例,出生17例,其中16例预后良好,1例夭折。产前超声诊断符合率为78.3%(18/23)。结论胎儿泌尿系统畸形多为男性。加强产前超声检查可以减少漏误诊的发生。产前多学科会诊,可以科学咨询和把控引产指征。
Objective To investigate the characteristics and causes of prenatal ultrasound misdiagnosis and missed diagnosis of fetal urinary system malformations. Methods The characteristics of prenatal misdiagnosis of 23 cases of fetal urinary malformations and related prognostic follow-up data were analyzed. Results 15 cases were misdiagnosed in prenatal period, including 7 cases of pelvic ectopic kidney (46.7%, 7/15), 4 cases of hydronephrosis (26.7%, 4/15), 2 cases of repeated kidney and 1 case of infantile polycystic kidney And horseshoe kidney in 1 case; 8 cases missed diagnosis, including 5 cases of external genital malformations (62.5%, 5/8), 1 case of ureterocele, 1 case of ectopic renal pelvic hernia and 1 case of bladder eversion. There were 17 males (17.9%), 17 males (17.4%) and 2 females (8.7%, 2/23) in 17 males. Of the 22 routine prenatal and multidisciplinary consultations, 6 were induced abortion and 17 were born, of which 16 had a good prognosis and 1 died prematurely. The coincidence rate of prenatal ultrasound was 78.3% (18/23). Conclusion Fetal urinary system malformations are mostly male. Strengthening prenatal ultrasound can reduce the occurrence of misdiagnosis. Multidisciplinary prenatal consultation, scientific advice and control of induced labor indications.