Chen Min, Lam Yung Hang, Lee Chin Peng, Tang Mary Hoi Yin
Department of Obstetrics and Gynaecology, The University of Hong Kong, Tsan Yuk Hospital, Hong Kong, China.
Prenat Diagn. 2004 Feb;24(2):92-7. doi: 10.1002/pd.798.
Ultrasound screening for fetal abnormalities is conventionally performed at 18 to 20 weeks of gestation. Recent data suggested that many fetal structural abnormalities could be detected by ultrasound examination at 12 to 14 weeks of pregnancy. In this study, we investigated the effectiveness of early ultrasound examination in the detection of fetal abnormalities in women aged 35 years or older.
From February 1998 to March 2001, pregnant women aged 35 or above were examined by transabdominal and transvaginal sonography between 12 and 14 weeks of gestation. If the anatomical survey was normal, the women underwent routine 16- to 20-week ultrasound examination. Pregnancy outcome was obtained from the hospital records or by contacting the subjects.
Twenty-six of the 1609 fetuses had structural abnormalities. Fourteen were detected at the ultrasound examination at 12 to 14 weeks. Detection rate was 53.8% (14/26; 95% CI 44, 64) with a false-positive rate of 0.3% (5/1583; 95% CI 0.16, 0.44). Six additional abnormalities (23.1%, 6/26) were detected at 16- to 20-week ultrasound examination. The overall detection rate of structural abnormalities was 76.9% (20/26; 95% CI 68.6, 85.2).
The effectiveness of ultrasound examination at 12 to 14 weeks to screen for fetal abnormalities approached that achieved at 20 weeks and can be a good adjunct to the conventional examination.
胎儿异常的超声筛查传统上在妊娠18至20周进行。最近的数据表明，许多胎儿结构异常可在妊娠12至14周通过超声检查检测到。在本研究中，我们调查了早期超声检查对35岁及以上女性胎儿异常的检测效果。
从1998年2月至2001年3月，对35岁及以上的孕妇在妊娠12至14周期间进行经腹和经阴道超声检查。如果解剖学检查正常，这些女性接受常规的16至20周超声检查。妊娠结局从医院记录中获取或通过联系受试者获得。
1609例胎儿中有26例存在结构异常。14例在12至14周的超声检查中被检测到。检测率为53.8%（14/26；95%可信区间44, 64），假阳性率为0.3%（5/1583；95%可信区间0.16, 0.44）。另外6例异常（23.1%，6/26）在16至20周的超声检查中被检测到。结构异常的总体检测率为76.9%（20/26；95%可信区间68.6, 85.2）。
12至14周超声检查筛查胎儿异常的效果接近20周时的效果，可作为传统检查的良好辅助手段。
