Diagnostic results of fetal central nervous system malformation by ultrasound examination in early pregnancy of a Hospital
Objective To investigate the results of standardized ultrasound screening for fetal central nervous system(CNS)malformations in the first trimester(11-13+6 weeks)in Zhengzhou Maternal and Child Health Care Hospital,to evaluate the clinical diagnostic efficiency.Methods Totally 25 362 pregnant women who underwent the free NT screening during 11-13+6 weeks in Zhengzhou Maternal and Child Health Care Hospital from April 2020 to December 2022.Routine transabdominal ultrasound scans were performed according to standards,transvaginal ultrasound examinations were per-formed in abnormal cases,the follow-up results were used as the gold standard to evaluate the diagnostic efficacy.Results Among 25 362 pregnant women,there were 128 positive cases in the first trimester ultrasound screening,19 cases with CNS abnormalities:Including 8 cases of anencephaly or exencephaly,2 cases of meningocele,4 cases of holoprosen-cephaly,2 cases of spina bifida,and 3 cases of abnormal spinal alignment.Among them,1 case was misdiagnosed(1/19),holoprosencephaly diagnosed by ultrasound was confirmed as cerebellar dysplasia at 20 weeks;The coincidence rate of standardized ultrasonographic screening in detection of fetal CNS malformations in the first trimester was 94.73％(18/19).No significant abnormalities were found in the first trimester,while 13 cases were turned out to be abnormal in the second and third trimesters,including 4 cases of ependymal cyst,2 cases of hydrocephalus,1 case of lobar holoprosenceph-aly,l case of abnormal development of the corpus callosum,1 case of Dany-Walker syndrome,2 cases of giant choroid plexus cyst,and 2 cases of arachnoid cyst.Conclusion Fetal central nervous system malformations detected by standard-ized ultrasound screening in the first trimester are all serious abnormalities,which can provide a basis for early clinical in-tervention measures.However,the diagnosis of fully developed structures and late-onset CNS abnormalities in the second and third trimesters still requires systematic ultrasound examination.
Transabdominal ultrasoundTransvaginal ultrasoundPrenatal11-13+6 weeksStandardized ultrasonograph-ic screeningFetal central nervous system malformations
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