Department of Obstetrics and Gynecology, National Cheng Kung University College of Medicine and National Cheng Kung University Hospital, Tainan, Taiwan.
Taiwan J Obstet Gynecol. 2013 Jun;52(2):192-6. doi: 10.1016/j.tjog.2013.04.007.
In order to compare the trends and improvements of prenatal diagnosis of gastroschisis, we herein retrospectively reviewed our cases of fetal gastroschisis detected by three-dimensional ultrasound (3D US) between the two centuries.
We reviewed our computer database of prenatal diagnosis on gastroschisis in National Cheng Kung University Hospital from October 1994 to November 2011. All the fetuses were initially scanned by two-dimensional (2D) US to locate the region of interest (ROI). Then, the 3D probe was used to scan all the ROI systematically and mechanically, and all the images were stored on laser discs for further 3D visualization and reconstruction. To compare the characteristics at prenatal diagnosis of gastroschisis between the 20th and 21st centuries in our hospital, the Chi-square test and Student t test were used. The p values less than 0.05 and 0.1 were considered statistically significant.
In total, 26 fetuses with gastroschisis were depicted by 3D US in utero (10 cases were diagnosed in the 20th century and 16 cases in the 21st century). The ranges of gestational age at prenatal diagnosis of gastroschisis by 3D US in the 20th century were between 14 and 34 weeks (mean: 21.6 weeks) and between 14 and 33 weeks (mean: 21.9 weeks) in the 21st century. Moreover, seven cases (70%) were diagnosed before the third trimester in the 20th century, whereas 13 cases (81%) were diagnosed before the third trimester in the 21st century.
Although without statistical significance, higher prenatal diagnosis rate before the third trimester in the 21st century was noted. The improvement of 3D US has remarkable advantages in adding novel visual depiction of a 3D lesion of a 3D fetus in 3D US after reconstruction and thus assists substantially in prenatal diagnosis, genetic consultation, and perinatal management of gastroschisis.
为了比较先天性腹裂产前诊断的趋势和改善，我们回顾性地分析了两个世纪以来通过三维超声（3D US）检测到的胎儿腹裂病例。
我们回顾了 1994 年 10 月至 2011 年 11 月在国立成功大学医院进行的产前诊断腹裂病例的计算机数据库。所有胎儿均首先通过二维（2D）US 扫描定位感兴趣区域（ROI）。然后，使用 3D 探头对所有 ROI 进行系统和机械扫描，并将所有图像存储在激光光盘上，以便进一步进行 3D 可视化和重建。为了比较我院 20 世纪和 21 世纪胎儿腹裂产前诊断的特点，采用卡方检验和学生 t 检验。p 值小于 0.05 和 0.1 被认为具有统计学意义。
共有 26 例胎儿通过 3D US 在子宫内显示出腹裂（20 世纪 10 例，21 世纪 16 例）。20 世纪通过 3D US 产前诊断腹裂的孕龄范围为 14 至 34 周（平均：21.6 周），21 世纪为 14 至 33 周（平均：21.9 周）。此外，20 世纪有 7 例（70%）在孕晚期前诊断，而 21 世纪有 13 例（81%）在孕晚期前诊断。
虽然没有统计学意义，但在 21 世纪，孕晚期前的产前诊断率更高。3D US 的改进在通过重建后对 3D 胎儿的 3D 病变进行新的视觉描述方面具有显著优势，因此对先天性腹裂的产前诊断、遗传咨询和围产期管理有很大帮助。
