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1.
目的:探讨超声心动图检测胎儿心包积液的临床意义。方法:2007-2010年在我院检查行超声心动图检查的高危孕妇473例,同时设对照组,检测孕龄在20-40周无明显高危妊娠因素的孕妇472例,并将产前超声检查结果和胎儿尸检或分娩后超声心动图检查结果进行对照。结果:1.高危组检出72例心包积液,检出率12.5%,对照组检出13例心包积液,检出率3%,两组胎儿心包积液检出率间差别有统计学意义(x2=39.57,P<0.05)。2.85例心包积液中,孤立性心包积液38例,伴其他心脏畸形或者其他系统畸形47例,其中孤立性心包积液预后良好。结论:超声心动图能够敏感地检出胎儿心包积液;心包积液程度并不是最重要的,其伴随心脏畸形或者其他畸形决定预后。  相似文献   

2.
摘要 目的:探讨超声联合染色体检测对胎儿心血管畸形的诊断价值。方法:2017年6月到2020年12月选择在本院诊治的高危孕妇117例作为研究对象,所有孕妇都给予胎儿心脏超声检查与羊膜穿刺染色体检查,判断胎儿心血管畸形情况。结果:在117例孕妇中,胎儿心脏超声检出胎儿心血管畸形37例,占比31.6%,前三位主要为室间隔缺损、左上腔静脉、右锁骨下动脉。羊膜腔穿刺术检出32例染色体异常胎儿,占比27.4%,其中染色体数目异常30例,染色体结构异常2例,前三位分别为21-三体、13-三体与18-三体。超声检查胎儿心血管畸形37例中,染色体异常30例;超声检查胎儿心血管正常80例中,染色体异常2例,对比差异有统计学 意义(P<0.05)。联合诊断为胎儿心血管畸形39例,随访后确诊为胎儿心血管畸形40例,超声联合染色体检测对胎儿心血管畸形的敏感性与特异性为100.0%(39/39)和98.7%(77/78)。结论:胎儿心脏超声联合染色体检测对胎儿心血管畸形的诊断具有很高敏感性与特异性,可尽最大可能提高出生缺陷儿的检出率,有很好的应用价值。  相似文献   

3.

AIM:

The presence of circulatory cell-free fetal DNA in maternal plasma has found new applications in non-invasive risk-free prenatal diagnosis.

MATERIALS AND METHODS:

We made use of a size separation approach along with real time polymerase chain reaction (PCR) to evaluate the use of fetal DNA in the detection of the sex of the fetus. Cell-free fetal DNA was isolated from the plasma of 30 women (10–20 weeks gestation) using a size separation approach. We made use of Taq Man Chemistry and real time PCR using primers and probes for GAPDH and SRY.

RESULTS:

Only 24 cases could be studied as there was no amplification in six cases. Fetal sex was accurately determined in all of the 24 cases wherein 19 women were carrying male fetuses and five women were carrying female fetuses. An increase in the amount of fetal DNA was observed with an increase in the gestational age.

CONCLUSIONS:

Real time PCR analysis is a highly sensitive and accurate tool for non-invasive prenatal diagnosis, allowing detection of the sex of the fetus as early as 10 weeks of gestation. Non-invasive prenatal diagnosis eliminates the risk of fetal loss associated with the invasive procedure.  相似文献   

4.
目的:探讨超声系统筛查在孕早期胎儿中枢神经系统先天畸形诊断的价值分析。方法:选取2014年3月~2017年4月来我院超声科行孕早期胎儿颈部透明层(Nuchal translucency,NT)筛查的孕妇2084例,胎儿共2135例。采用超声测量胎儿头臀长(Croen rump length,CRL)和颈部透明层(Nuchal translucency,NT)值,通过头胸部正中矢状断面、侧脑室水平横断面、小脑及后颅窝池断面、脊柱长轴断面等4个超声影像标准断面对孕早期胎儿的中枢神经系统解剖结构进行系统检查,统计各组在上述4个超声标准断面的检查显示情况及NT值,同时分析NT值、标准断面显示率与孕龄的关系,统计分析孕早期应用超声影像标准断面检查对中枢神经系统畸形的检出率、诊断敏感度、特异度、阳性预测值、阴性预测值。结果:孕早期胎儿采用超声检查,结果显示头胸部正中矢状断面、侧脑室水平横断面、小脑及后颅窝池断面、脊柱长轴断面的超声影像学显示率分别为98.17%、99.44%、98.78%和98.97%,不同孕龄组间超声断面显示率差异对比,x~2检验值分别为0.25、1.65、0.62、0.13,差异无统计学意义(P0.05);孕早期超声诊断胎儿中枢神经系统畸形的敏感度为90.91%,特异度为100%,阳性预测值为100%,阴性预测值为99.48%;正常胎儿的NT值与其孕龄呈正相关(r=0.153)。结论:超声检查对孕早期胎儿中枢神经系统结构畸形的显示率较高,且不受胎儿孕龄影响。  相似文献   

5.
Pregnant Rhesus monkeys were infected via installation of Western Equine Encephalomyelitis (WEE) vaccine virus into the amniotic sacs at 50 and 80 days gestation to determine if the resulting infections would produce fetal mortality or fetal malformations, particularly within the central nervous system. Of those receiving virus at 50 days gestation, 13 of 18 fetuses were aborted or dead in utero at time of Caesarean section; 2 of 18 were malformed (hydrocephalus and polyarthrosis); and 3 of 18 were anatomically normal. Of those receiving virus at 80 days gestation four of eight fetuses were aborted or dead in utero at time of Caesarean section, one of eight was malformed (hydrocephalus) and three of eight were anatomically normal. Three of three controls receiving neutralized virus at each gestational age were anatomically normal. Fetal WEE vaccine virus infection significantly increased fetal mortality and resulted in a significant incidence of fetal malformations.  相似文献   

6.
目的:探讨超声心动图检测胎儿心包积液的临床意义。方法:2007-2010年在我院检查行超声心动图检查的高危孕妇473例,同时设对照组,检测孕龄在20-40周无明显高危妊娠因素的孕妇472例,并将产前超声检查结果和胎儿尸检或分娩后超声心动图检查结果进行对照。结果:1.高危组检出72例心包积液,检出率12.5%,对照组检出13例心包积液,检出率3%,两组胎儿心包积液检出率间差别有统计学意义(x2=39.57,P〈0.05)。2.85例心包积液中,孤立性心包积液38例,伴其他心脏畸形或者其他系统畸形47例,其中孤立性心包积液预后良好。结论:超声心动图能够敏感地检出胎儿心包积液;心包积液程度并不是最重要的,其伴随心脏畸形或者其他畸形决定预后。  相似文献   

7.
The ductus venosus is the very important part of fetal venous circulation. It plays a central role in return of venous blood from the placenta. This unique shunt carries well-oxygenated blood from the umbilical vein through the inferior atrial inlet on its way across the foramen ovale. Using Doppler ultrasound, it is possible to assess the blood flow in fetal vessels including ductus venosus. It is observed, in animal and human studies, that the typical waveform for blood flow in ductus venosus in early pregnancy can be different depending on numerous conditions e.g. fetal karyotype. This study is performed to assess the physiologic parameters of blood flow in ductus venosus in uncomplicated early pregnancy. Material and Methods: 404 women were examined between 11+0 and 13+6 weeks (+ days) of gestation by ultrasound. Fetal crown-rump length (CRL) was measured to assess the gestational age. The assessment of risk of fetal abnormalities was based on nuchal translucency (NT) measurement. The ductus venosus blood flow with color and spectral Doppler was obtained in all patients. The following features were assessed: pulsatility index (PI), and direction of flow (positive/negative) during atrial contraction (wave A). All cases were followed up to 22 weeks of gestation when the control scan was performed. Results and conclusions: 30 cases were excluded from the uncomplicated group due to: high risk of fetal abnormalities, fetal loss, confirmed fetal abnormalities and utero-placental pathology. 374 women were considered as uncomplicated pregnancy. In both uncomplicated and complicated groups the mean values for pulsatility index (PI) were established. The mean PI value in uncomplicated pregnancies was: 0.91 (SD +/- 0.32). No significant differences between groups were noticed. In 370 cases of uncomplicated pregnancy the A wave direction was positive but in 1.1% of cases the reverse flow in atrial contraction was observed.  相似文献   

8.
Developmental malformations are a major cause of childhood mortality and are typically characterized by lesions that allow survival of the embryo through gestation. The genetics of developmental malformations are powerfully studied by using high-throughput, phenotype-driven screens (e.g., following zebrafish or mouse mutagenesis) or by genotype-driven studies using transgenic or knockout mice. With regard to either approach, the mouse is anatomically and phylogenetically closer to humans than any other genetically tractable model organism. This is particularly important in the cardiovascular and respiratory systems, which have unique mammalian features. The identification of murine models of developmental malformations is, however, hindered by the opacity of the late gestational mouse embryo. In this review, we describe recent advances in magnetic resonance imaging that make it possible to rapidly identify malformations in the developing mouse embryo with high efficiency.  相似文献   

9.
Objective: To examine differences in late fetal death rates in association with determinants of small for gestational age fetuses. Design: Population based cohort study. Subjects: 1 026 249 pregnancies without congenital malformations. Setting: Sweden 1983-92. Main outcome measure: Late fetal death rate. Results: Depending on underlying determinants late fetal death rates were greatly increased in extremely small for gestational age fetuses (range 16 to 45 per 1000) compared with non-small for gestational age fetuses (1.4 to 4.6). In extremely small for gestational age fetuses late fetal death rates were increased from 31 per 1000 in mothers aged less than 35 years to 45 per 1000 in older mothers, and from 22 per 1000 in women <155 cm in height to 33 per 1000 in women ⩾175 cm tall. Late fetal death rates were also higher in extremely small for gestational age fetuses in singleton compared with twin pregnancies and in non-hypertensive pregnancies compared with pregnancies complicated by severe pre-eclampsia or other hypertensive disorders. Slightly higher late fetal death rates were observed in nulliparous compared with parous women and in non-smokers compared with smokers.Conclusions: Although the risk of late fetal death is greatly increased in fetuses that are extremely small for gestational age the risk is strongly modified by underlying determinants—for example, there is a lower risk of late fetal death in a small for gestational age fetus if the mother is of short stature, has a twin pregnancy, or has hypertension.

Key messages

  • Small for gestational age fetuses are at increased risk of late fetal death regardless of the underlying determinants
  • The effect of birthweight ratio on risk of late fetal death is modified by underlying determinants, except maternal age
  • Regardless of birthweight ratio the rates of late fetal death are higher among women aged 35 years or older compared with younger women
  • In pregnancies of extremely small for gestational age fetuses lower rates of late fetal death are associated with a maternal age of less than 35 years, short maternal stature, multiple births, and hypertensive disorders
  • In pregnancies with non-malformed fetuses late fetal death rates are increased in smokers, in multiple births, and in women with severe pre-eclampsia.
  相似文献   

10.
Non-invasive prenatal diagnosis tests based on the analysis of fetal DNA in maternal plasma have potential to be a safer alternative to invasive methods. So far, different studies have shown mainly fetal sex, fetal RhD, and quantitative variations of fetal DNA during gestation with fetal chromosomal anomalies or gestations at risk for preeclampsia. The objective of our research was to evaluate the use of fetal DNA in maternal plasma for clinical application. In our study, we have established the methodology needed for the analysis of fetal DNA. Different methods were used, according to the requirements of the assay. We have used quantitative fluorescent polymerase chain reaction (QF-PCR) to perform fetal sex detection with 90% sensitivity. The same technique permitted the detection of fetal DNA from the 10th week of gestation to hours after delivery. We have successfully carried out the diagnosis of two inherited disorders, cystic fibrosis (conventional PCR and restriction analysis) and Huntington disease (QF-PCR). Ninety percent of the cases studied for fetal RhD by real-time PCR were correctly diagnosed. The detection of fetal DNA sequences is a reality and could reduce the risk of invasive techniques for certain fetal disorders in the near future.  相似文献   

11.
The influence of maternal energy intake on the development of gluconeogenesis was studied in the liver of the bovine fetus from Days 88 to 270 of gestation. Fetal liver activities (units per gram of tissue) of cytoplasmic GTP:oxalacetate carboxy-lyase (transphosphorylating) (PEPCK) and mitochondrial l-malate:NAD+ oxidoreductase (MDH) increased linearly with increasing gestational age. Fetal cytoplasmic MDH activities reached maternal levels by 120 days of gestation, and fetal mitochondrial pyruvate carboxylase approached maternal levels by 200 days of gestation. Fetal activities of mitochondrial and cytoplasmic propionyl-CoA:carbondioxide ligase (ADP-forming) (PCC) did not change with gestational age and were about 45 and 7%, respectively, of maternal levels. Fetal activities of mitochondrial and cytoplasmic l-aspartate: 2-oxoglutarate aminotransferase were both about 24% of the maternal activities throughout gestation. Maternal and fetal liver activities of d-fructose-1,6-diphosphate 1-phosphohydrolase (FDP) were similar and did not change with gestational age. Glucose synthesis from lactate by fetal liver slices in vitro was slightly lower and, from alanine and aspartate, was slightly higher than glucose synthesis by maternal liver slices. Restriction of maternal dietary energy intake did not significantly alter gluconeogenic-related enzyme activity in vitro in maternal or fetal liver or in the metabolism of aspartate, alanine, or lactate to glucose or CO2 by liver slices in vitro. A capacity for gluconeogenesis has been measured in the bovine fetus as early as 88 days of gestation.  相似文献   

12.
摘要 目的:探讨应用超声SlowflowHD(超低速血流成像)联合RadiantFlow(二维立体血流成像)技术评估孕14-19+6周正常胎儿胼周动脉的可行性,观察胎儿胼周动脉及分支走行,测量其长度和高度,并探讨二者与孕周及双顶径的关系。方法:纳入2022年5月-2023年3月来南京医科大学附属苏州医院进行常规超声检查的150例孕14-19+6周孕妇,在胎儿正中矢状切面上获取胎儿胼周动脉及分支的图像,测量其长度和高度,测量重复3次,取平均值,并观察胎儿胼周动脉及分支走行。所有孕妇均随访至中孕晚期(20-28周)或晚孕期行产前超声检查未见胼胝体异常及其他颅内结构异常。采用pearson相关分析和回归分析判断胎儿胼周动脉长度及高度与孕周及双顶径的关系。结果:胎儿胼周动脉长度及高度随着孕周及双顶径的增加而增加(P<0.05)。胎儿胼周动脉长度与孕周、双顶径之间呈线性正相关,且胎儿胼周动高度与孕周、双顶径之间呈线性正相关(P<0.05)。在孕14-19+6周中所有111病例均类"C"形走行,额前内侧动脉、额中内侧动脉、额后内侧动脉三者几乎与胎儿胼周动脉垂直,类"鸡冠",三者显示率100%;旁中央动脉在孕14-15+6周、16-17+6周、18-19+6周显示率分别约53.1%(17/32)、88.2%(45/51)、92.8%(26/28);楔前动脉在孕14-15+6周、16-17+6周、18-19+6周显示率分别约3.1%(1/32)、35.2%(18/51)、78.5%(22/28)。结论:应用超声SlowflowHD(超低速血流成像)联合RadiantFlow(二维立体血流成像)技术显示孕14-19+6周正常胎儿胼周动脉及分支具有可行性,胎儿胼周动脉长度和高度与孕周及双顶径呈一定的线性相关。  相似文献   

13.
The aim of this study was to establish baseline ultrasound data concerning the mule conceptus during gestation. Ten multiparous Trotter mares were artificially inseminated with chilled semen from an Amiatino jack donkey. Daily transrectal ultrasonography was carried out from the day of ovulation until Day 50 of gestation to determine the following: first detection of the embryonic vesicle (EV), mobility phase, EV diameter, day of EV fixation, changes in EV shape, date of yolk sac regression and embryo crown-rump length. Monthly ultrasonic assessments from Day 50 of gestation to term were carried out. These assessments included an evaluation of fetal well-being and the growth of the mule conceptus, which were monitored using the following variables: cardiac activity, fetal activity and presentation, fetal fluid echogenicity, combined thickness of the utero-placenta unit and fetal orbital and aortic diameter. Mule EV first detection was observed earlier (37% at Day 8) than that observed in the equine pregnancy. EV diameter at first detection was 4.6 ± 1.1 mm. At Day 10, 75% of EVs were detected. EV fixation occurred on Day 17.1 ± 1.1, with a mean EV diameter of 2.5 ± 0.2 cm. EV growth rate was 4.04 mm/day from Days 11 to 16, 0.4 mm/day from Days 16 to 28 and 1.78 mm/day from Days 28 to 45 of pregnancy. The embryo proper was first detected on Day 19.9 ± 1.9 (average length 2.4 ± 1.4 mm), and the embryonic heartbeat was first detected on Day 24 ± 2.4. The fetal carotid pulse was observed at six months of gestation and provided a good means by which to estimate fetal cardiac activity in advanced gestation. The fetal heart rate was recorded from Month 2 of gestation to term. The mean ± SD of the combined uteroplacental thickness was assessed at the cervical-placental junction and at the ventral abdomen in mares between Months 2 and 5 until term, respectively. An abnormal fetal-placental unit and fetal inactivity was observed in association with abortion. Mule-conceptus biometric measurements correlated significantly with the gestational age, and these data were used to predict an unusually large mule fetus, which might result in dystocia. In conclusion, we can assume that early diagnosis of pregnancy failure and assessment of fetal biophysical profile and growth charts could improve the chances of gestation completion in mule-pregnant mares. The early detection of mares at risk for an abnormal pregnancy or delivery may increase the success of prompt treatments, therefore preventing costly emergency procedures and allowing proper obstetrical and neonatal assistance.  相似文献   

14.
Zinc deficiency (ZD) is teratogenic in rats, and fetal skeletal defects are prominent. This study identifies fetal skeletal malformations that affect calcified and non-calcified bone tissue as a result of gestational zinc deficiency in rats, and it assesses the effect of maternal ZD in fetal bone calcification. Pregnant Sprague-Dawley rats (180-250 g) were fed 1) a control diet (76.4 micrograms Zn/g diet) ad libitum (group C), 2) a zinc-deficient diet (0 microgram/g) ad libitum (group ZD), or 3) the control diet pair-fed to the ZD rats (group PF). On day 21 of gestation, laparotomies were performed. Fetuses were weighed, examined for external malformations, and stained in toto with a double-staining technique for the study of skeletal malformations. Maternal and fetal tissues were used for Zn, Mg, Ca, and P determinations. Gross external malformations were present in 97% of the ZD fetuses. No external malformations were found in fetuses from groups C and PF. Ninety-one percent of cleared ZD fetuses had multiple skeletal malformations, whereas only 3% of the fetuses of group PF had skeletal defects; no skeletal malformations were found in fetuses from group C. Some of the skeletal malformations described in the ZD fetuses, mainly affecting non-calcified bone, were not mentioned in previous reports, thus stressing the importance of using double-staining techniques. Examination of stained fetuses and counting of ossification centers revealed important calcification defects in ZD fetuses. These effects were confirmed by lower Ca and P concentrations in fetal bone with alteration of the Ca:P ratio.  相似文献   

15.
The purpose of the study was to investigate the potentialities of magnetic resonance imaging (MRI) in the complex of prenatal radiation diagnosis of fetal malformations. Twenty-eight female patients with suspected fetal malformations were examined. Ultrasound study was supplemented by MRI according to a specially developed protocol. Various fetal CNS malformations were diagnosed. These included the Arnold-Chiari syndrome, the Dandy-Walker syndrome, occlusive hydrocephaly, lobular holoprosencephaly, porencephaly, diaphragmatic hernias, anomalies of the abdomen and retroperitoneal space, as well as anomalies of facial structures, including median clefts, and dacryocystocele. The use of MRI in the complex prenatal radiation diagnosis makes it possible to visualize fetal malformation more clearly, contributes to the more adequate prediction of the outcome of pregnancy and to the choice of a management policy for a female patient.  相似文献   

16.
目的:研究妊娠中晚期轻度侧脑室增宽胎儿的超声表现以及妊娠结局情况。方法:回顾性分析我院产前诊断的60例轻度侧脑室增宽的胎儿的声像图资料,均经引产或产后随访证实。结果:60例胎儿中,孤立性者42例,合并其它畸形的轻度侧脑室增宽者18例(1例NTD高风险,2例21-三体高风险)。30例单侧,30例双侧,脑室宽度为10.5~14.5 mm,平均宽度13.1 mm。22例终止妊娠,32例(包括2例双胎之一)产前超声侧脑室随访变为正常宽度,4例产后随访正常,2例产后超声和MRI证实为脑积水。结论:超声是诊断胎儿轻度侧脑室增宽的重要影像学手段,对指导妊娠结局有重要意义。  相似文献   

17.
Fetal malformations may introduce complications of maternal pregnancy. A polyhydramnios represents one such complication during pregnancy. We want to report five abnormal pregnancies which were marked by acute polyhydramnios and/or premature labor due to an amniotic band syndrome associated with cerebral herniation in two cases, malignant oral teratoma in one case, bilateral cystic hygromas associated with generalized fetal hydrops in one case, and multiple internal malformations in one case alpha-fetoprotein (AFP) values between the 25th and 34th week of gestation were elevated 3.5 to 44 times the normal median value. Since all fetuses showed severe malformations incompatible with life our observations indicate the necessity to determine AFP in cases of acute polyhydramnios independent of the week of gestation. Conversely, elevated AFP levels in amniotic fluid obtained during prenatal diagnosis in the 16th week of gestation may also suggest rare fetal malformations outlined above.  相似文献   

18.
The study was undertaken to optimize the diagnosis of fetal CNS and facial malformations, by using a complex of ultrasound (US) and magnetic resonance imaging (MRI) studies. A hundred and forty-four fetuses with suspected CNS and facial malformations were examined. The US study conducted by a specially developed protocol was supplemented by MRI (48 fetuses) also made by a specially developed protocol. Various fetal CNS malformations, such as neural tube defects, congenital endbrain malformations, cystic lesions, tumors, ventricular complex anomalies, defects of the face and eyes, multiple defects, including CNS and facial anomalies, were detected. With MRI, the diagnosis was changed in 33% of cases. The application of a complex of US and MRI studies enhances the efficiency of diagnosis of congenital CNS and facial malformations in the fetus. MRI in the diagnosis of fetal CNS and facial malformations has a number of advantages and should be used if there is some difficulty in establishing a diagnosis when an US study is performed.  相似文献   

19.
Summary Confined placental chorionic mosaicism is reported in 2% of viable pregnancies cytogenetically analyzed on chorionic villi samplings (CVS) at 9–12 weeks of gestation. In follow-up studies this mosaicism has been shown to be associated with increased frequency of second and third trimester pregnancy loss or intrauterine fetal growth retardation. We have studied 54 spontaneous abortions (SA) for the detection of confined placental mosaicism and found 11 of them to be mosaic. All mosaic cases were identified among first trimester spontaneous abortions, and the mosaicism was confined to specific placental or embryonic/fetal cell lineages. These results indicate that the previously reported mosaicism in SA represents both confined and generalized types of mosaicism and that its accepted frequency of 5%–10% in SA will likely be higher. Over the whole gestational period, the confined placental mosaicism is more common than the reported rate of 1%–2% seen in viable pregnancies at CVS, and a higher proportion of pregnancy complications than previously suspected may be associated with confined placental mosaicism.  相似文献   

20.
Ultrasound imaging has been used to elucidate certain aspects of the reproductive biology of wild or endangered species. However, to our knowledge, this tool has not been used for reproductive monitoring of the collared peccary (Tayassu tajacu). In this study, real-time ultrasonography was used in 16 collared peccary females to diagnose early pregnancy status and predict gestational age. Based on the detection of an embryo, the earliest pregnancy diagnosis was made on Day 18 after mating, with the mean time needed for diagnosis being 22 days. Overall accuracies on Days 22, 26 and 28 were 56, 93, and 100%, respectively. On Days 26 and 28, all pregnancy and non-pregnancy diagnoses, respectively, were correct. The fetal measurements that best correlated with gestational age were crown-rump-length (CRL) and the length and diameter of the thorax. CRL was considered the most practical measurement because, contrary to thoracic fetometry, it could be determined when the embryo was first detected. Our findings revealed real-time ultrasound scanning to be a very accurate method for early pregnancy diagnosis and prediction of gestational age in the collared peccary.  相似文献   

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