Edwards M S, Ellings J M, Newman R B, Menard M K
Prenatal Wellness Center, Medical University of South Carolina, Charleston 29425-2233, USA.
Ultrasound Obstet Gynecol. 1995 Jul;6(1):43-9. doi: 10.1046/j.1469-0705.1995.06010043.x.
The purpose of this study was to evaluate the accuracy of antenatal ultrasonography in the detection of fetal anomalies among twin gestations cared for in a specialized antepartum twin clinic. A retrospective study was performed of 245 consecutive twin gestations followed in our twin clinic. The sensitivity, specificity and diagnostic indices of ultrasound to detect prenatal anomalies in the 490 infants delivered from July 1988 to October 1994 were determined. Fourteen infants had isolated congenital anomalies, and ten had multiple anomalies. The overall prevalence of congenital anomalies was 4.9%. Antepartum ultrasound examination had a sensitivity of 88% and a specificity of 100% for the detection of an anomalous infant, with a positive predictive value of 100% and a negative predictive value of 99%. The sensitivity of ultrasound for each individual anomaly within the cohort was 82%, with 100% specificity, 100% positive predictive value, and 98% negative predictive value. Our conclusions are that serial antepartum ultrasound examination of twins for congenital anomalies in our institution is very specific, with high positive and negative predictive values. The sensitivity, while also excellent, has limitations, which should be discussed with the patient.
本研究的目的是评估在一家专业产前双胎门诊接受护理的双胎妊娠中，产前超声检查对胎儿异常的检测准确性。对在我们双胎门诊连续随访的245例双胎妊娠进行了一项回顾性研究。确定了1988年7月至1994年10月分娩的490例婴儿中超声检测产前异常的敏感性、特异性和诊断指标。14例婴儿有孤立性先天性异常，10例有多发异常。先天性异常的总体患病率为4.9%。产前超声检查对异常婴儿的检测敏感性为88%，特异性为100%，阳性预测值为100%，阴性预测值为99%。队列中超声对每种个体异常的敏感性为82%，特异性为100%，阳性预测值为100%，阴性预测值为98%。我们的结论是，在我们机构中，对双胎进行系列产前超声检查以检测先天性异常具有很高的特异性，阳性和阴性预测值都很高。敏感性虽然也很好，但有局限性，应与患者讨论。
