Grandjean H, Larroque D, Levi S
National de la Santé et de la Recherche Mèdicale, Hopital Universitaire Brugmann, Toulouse, France.
Am J Obstet Gynecol. 1999 Aug;181(2):446-54. doi: 10.1016/s0002-9378(99)70577-6.
The purpose of the Eurofetus Study was to evaluate the accuracy of the antenatal detection of malformations by routine ultrasonographic examination in unselected populations.
All ultrasonographic diagnoses of malformations and the outcomes of the fetuses were prospectively recorded in 61 European obstetric units over a 3-year period (1990-1993). Also recorded were all cases of malformation diagnosed after abortion or birth for the mothers who underwent follow-up in these centers.
Of 3685 malformed fetuses, 2262 had received diagnoses during pregnancy (sensitivity, 61.4%). Of a total number of 4615 malformations, 2593 were detected (sensitivity, 56.2%). The detection sensitivity was higher for the major than for the minor abnormalities (73.7% vs 45.7%), and the diagnosis was made earlier in the pregnancy (24.2 weeks vs 27.6, P <. 01). Overall, 55% of the major abnormalities were detected within 24 gestational weeks. Within each severity group the accuracy of detection depended on the system. For the major abnormalities it was better for the central nervous system (88.3%) and urinary tract (84. 8%) but lower for the heart and great vessels (38.8%). Detection of minor abnormalities was also effective for the urinary tract (89.1%) but not for the heart and great vessels (20.8%) or the musculoskeletal system (18%). Detection of abnormalities had an influence on the rate of termination of pregnancy. The rate of live births for the mothers bearing fetuses with major abnormalities was lower than that for the mothers in whom no abnormalities were detected, mainly because of the higher rate of elective terminations of pregnancy in the former group.
Systematic ultrasonographic screening during pregnancy can now detect a large proportion of fetal malformations, although some still escape detection.
欧洲胎儿研究的目的是评估在未经过筛选的人群中，通过常规超声检查进行产前畸形检测的准确性。
在3年期间（1990 - 1993年），61个欧洲产科单位前瞻性地记录了所有超声诊断的畸形情况以及胎儿的结局。还记录了在这些中心接受随访的母亲在流产或分娩后诊断出的所有畸形病例。
在3685例畸形胎儿中，2262例在孕期得到诊断（敏感性为61.4%）。在总共4615例畸形中，检测出2593例（敏感性为56.2%）。主要畸形的检测敏感性高于次要畸形（73.7%对45.7%），且诊断在孕期更早做出（24.2周对27.6周，P < 0.01）。总体而言，55%的主要畸形在妊娠24周内被检测到。在每个严重程度组中，检测的准确性取决于系统。对于主要畸形，中枢神经系统（88.3%）和泌尿系统（84.8%）的检测效果较好，但心脏和大血管的检测效果较低（38.8%）。次要畸形的检测对泌尿系统也有效（89.1%），但对心脏和大血管（20.8%）或肌肉骨骼系统（18%）无效。畸形的检测对终止妊娠率有影响。怀有主要畸形胎儿的母亲的活产率低于未检测到畸形的母亲，主要是因为前一组的选择性终止妊娠率较高。
孕期系统性超声筛查现在可以检测出很大一部分胎儿畸形，尽管仍有一些畸形未被检测到。
