Weisz Boaz, Pajkrt Eva, Jauniaux Eric
Department of Obstetrics and Gynaecology, University College London, WC1E 6HX, London, UK.
Reprod Biomed Online. 2005 Apr;10(4):541-53. doi: 10.1016/s1472-6483(10)60832-2.
Most published data on the detection of fetal anomalies at 11-14 weeks are from specialized centres with considerable experience in fetal anomaly scanning. However, there is still limited information on the feasibility and limitations of the screening of these anomalies compared with the now classical mid-gestation screening. This review indicates that overall, the detection rate of fetal anomalies at 11-14 weeks is 44% compared with 74% by the mid-pregnancy scan. Major abnormalities of the fetal head, abdominal wall and urinary tract, and of the umbilical cord and placenta, can be reliably detected at 10-11 weeks of gestation. Detection of other anomalies such as spina bifida, diaphragmatic hernia or heart defects is limited before 13 weeks of gestation. So far it cannot be stated that routine first trimester screening can be used on a large scale to evaluate the fetal spine and heart in the general population. In particular, in screening for congenital heart defects, the ability to perform a full cardiac examination increases from 20% at 11 weeks to 92% at 13 weeks. The early prenatal diagnosis of these anomalies may be improved by screening at 13-14 weeks rather than during the first trimester.
大多数关于孕11至14周胎儿异常检测的已发表数据来自在胎儿异常扫描方面有丰富经验的专业中心。然而，与现在经典的孕中期筛查相比，关于这些异常筛查的可行性和局限性的信息仍然有限。这篇综述表明，总体而言，孕11至14周胎儿异常的检出率为44%，而孕中期扫描的检出率为74%。胎儿头部、腹壁和泌尿系统以及脐带和胎盘的主要异常在妊娠10至11周时可以可靠地检测到。在妊娠13周之前，对其他异常如脊柱裂、膈疝或心脏缺陷的检测是有限的。到目前为止，还不能说常规的孕早期筛查可以大规模用于评估普通人群中的胎儿脊柱和心脏。特别是在先天性心脏病筛查中，进行全面心脏检查的能力从11周时的20%增加到13周时的92%。这些异常的早期产前诊断通过在孕13至14周而不是孕早期进行筛查可能会得到改善。
