Rosendahl H, Kivenen S
Department of Obstetrics and Gynecology, Central Hospital of Kanta-Häme, Hämeenlinna, Finland.
Obstet Gynecol. 1989 Jun;73(6):947-51. doi: 10.1097/00006250-198906000-00008.
Routine ultrasound examination was performed in 9012 fetuses of a general pregnant population to detect fetal malformations. The examination was done on 3098 fetuses at 18 weeks, and on 5914 fetuses it was repeated at 34 weeks. Ninety-three infants (1.03%) showed 123 major malformations, of which 65 (52.8%) in 54 children were visualized in utero. The sensitivity of detection of malformed fetuses was 58.1% (54 of 93), specificity 99.9%, positive predictive value 91.5%, and negative predictive value 99.6%. Five fetal hydronephroses were the only false-positive cases (0.06%), with apparent spontaneous resolution after birth. Fetal growth retardation, polyhydramnios, or oligohydramnios was observed in 43% of the malformed cases, suggesting the importance of these conditions in ultrasound screening. Abnormality of pregnancy was suspected clinically in only 25.8% of the cases at the time of diagnosis of fetal malformation, emphasizing the necessity for ultrasound examination of all pregnancies.
对9012名普通孕妇的胎儿进行常规超声检查以检测胎儿畸形。在18周时对3098名胎儿进行了检查，在34周时对5914名胎儿进行了复查。93名婴儿（1.03%）出现了123处严重畸形，其中54名儿童的65处（52.8%）畸形在子宫内得以可视化。畸形胎儿的检测敏感度为58.1%（93例中的54例），特异度为99.9%，阳性预测值为91.5%，阴性预测值为99.6%。5例胎儿肾盂积水是仅有的假阳性病例（0.06%），出生后明显自行消退。43%的畸形病例观察到胎儿生长受限、羊水过多或羊水过少，提示这些情况在超声筛查中的重要性。在诊断胎儿畸形时，临床上仅25.8%的病例怀疑妊娠异常，强调了对所有妊娠进行超声检查的必要性。
