The Study Of Effect Of Surveillance Of Umbilical Artery Flow Velocity Waveforms In Prenatal Diagnosis Of Congenital Fetal Malformations And Pregnant Woman's High Risk Factors

Objective Congenital malformation (CM) is the main cause of fetal and infant death. The occurrence of CM is the result of hereditary factors and environmental factors as well as the interaction of the above two. Prenatal diagnosis can find malformations earlier so as to decrease the birthrate of CM. With the development of medicine, more and more congenital malformations can be diagnosed during prenatal period. Ultrasound examination is especially helpful for detecting fetal structural anomalies but there are some limitations. The diagnostic rate of CM by ultrasound is intensively relevant to doctor's skill and sensitivity of ultrasound facility. Ultrasonic image is based on morphological information, So, The reports of fetal autopsy by pathologists make the most important contributions for ultrasonic medicine, the outcome of prenatal diagnosis and genetic counseling. It is the only way to confirm diagnosis. The aims of this study were to observe pathological morphological information of all kinds of congenital malformations, study the systolic/diastolic (S/D) ratio in the umbilical artery of fetal anomalies, investigate high risk factors, and analyze the information of prenatal diagnosis at the same time.Methods This study recruited 42 abnormal fetuses and 50 normal fetuses, all cases had detailed clinical data; The general inspection and fetal autopsy were performed in abnormal fetuses; Umbilical artery flow velocity waveforms were operated in fetal anomalies and normal fetuses in order to investigate its clinical significance; The clinical data of pregnant women with abnormal fetuses and normal newborn were analyzed in order to investigate the causes of the deformities as well as the related factors.Results The 42 fetuses had various structural abnormalities by pathologic diagnosis. The incidence of the fetal malformations was 2.89% of all 1455 newborns at the corresponding period in our research. 10 systems and 26 kinds of the deformities were found in this study. We studied the system malformation times and disease malformation times in all abnormal cases, which indicated that 64.81% malformations were edema, digestive, nervous and cardiovascular system.The outcome of amniotic fluid volume as follows: The incidence of polyhydramnios or oligohydramnios showed significant statistic difference between abnormal fetuses and normal ones (P=0.000 <0.01)). Amniotic fluid volume between single system and multiple system malformations in abnormal fetuses was not studied, beacuse multiple system malformations only had 5.The S/D values of fetal anomalies were higher than that of normal fetuses (P < 0. 01). The S/D values of central nervous system and respiration system malformations were recognized statistics difference (P<0.05), but these of mult-imalformations, gastrointestinal tract, cardiovascular, urinary system malformations and edema fetuses were recognized significant statistic difference (P <0.01).The logistic statistics displayed that career (OR=5.643,P<0.05), pergnantwomen with flu symptoms(OR=3.548,P<0.05), threatened abortion history (OR=5.518, P<0.05), fetal abnormality history (OR=4.218, P<0.05) and abnormal exposure history(OR=4.026, P<0.05 ), smoking and sot history (OR=2.875, P< 0.05 ) were risk factors for congenital malformations.Conclusions1. Mult-imalformations, gastrointestinal tract, central nervous, cardiovascular system malformations can make S/D value high. So, if pregnant woman has no hypertensive disorder complicating pregnancy etc, when S/D value is abnormal, fetal anomalies is much paid to attention. The examination of B ultrasound, fetal blood or amniotic fluid cytology is very necessary.2. There are some certain relationship between polyhydramnios or oligohydramnios and fetal abnormities. The examination of umbilical artery flow velocity waveforms and the analysis of chromosomal karyotype should be done in congenital malformations.3. Prenatal diagnosis and pathological study on congenital malformations are very important.4. These factors are close to congenital fetal malformations, including pregnant woman age, occupation, cold and fever history in the early pregnancy, threatened abortion history, fetal abnormality history, abnormal exposure history and smoking and sot history.