Research Of NT Ultrasound Screening For Fetal Major Abnomalities And Uterine Artery Doppler During12⁺³ï½ž13⁺⁶ Weeks

Part I Fetal anatomic NT ultrasound sections and their values at12+3~13+6weeksObjective:The various anotomic NT ultrasound sections of the fetus at12+3~13+6weekswere studied to screen for fetal abnomolities and significance of these sections.Materials and methods:By abdominal ultrasound，304fetus were screened successively for38standardsectionsa.Based on our experience of ultrasound examination of the fetuses in the firsttrimester of pregnancy in the past one years，according to standards of the British fetalmedicine foundation standards and the anatomic ultrasound sections in the secondtrimester of pregnancy. The sonographic features in different sections of various fetalmalformations were studied and the necessary ultrasound sections of each fetus in theprenatal ultrasound examination were analysed.The specification of these sections inhealthy fetus was provided to minimize the misdiagnosis.Result:The various ultrasound sections of the fetus were analysed and38ultrasoundsections of the fetus were necessarily obtained in fetal abnomolities screening at12+3~13+6weeks.Most of the fetal malformations can be recognized and diagnosed byscanning these sections and the detection rate of fetal abnormalities would beincreased.Conclusion:The38standard sections in the first trimister of pregnancy is very important forscreening fetal structural abnormalities, not only early detection of fetalmalformation, improving the deformity rate, but also helpful of studying for beginner. Part II Research of NT ultrasound screening for fetal major abnomalitiesduring12+3~13+6weeksObjective:The clinical value of first-trimester standard ultrasound views in screening forfetal structural abnormalities.Materials and methods:From October2013to October2014，transabdominal sonographic screening by38standard ultrasound views was performed in304viable singleton pregnanciesduring the first trimester at Jilin University’s hospital.The women underwent furtherultrasound examination if the anatomical survey was normal during the firsttrimester.Follow-up was obtained by reviewing of the birth records from hospitalcharts.Result:1.Thirteen prenatal major abnormalities were detected at12+3-to13+6-weekscan(including three cases of heart abnormalities，four cases of exencephaly，threecases of omphalocele， six cases of cystic hygroma and one case of renalagenesis.The13women decided on termination of pregnancy.2.Screening for fetal abnormalities by standard ultrasound views,morbidity is5.59%，sensitivity is76.47%， specifility is100%.3.The percentage of heart malformation is9.9‰（3/304) in304fetus.Theprevalence of heart abnormalities is100%（3/3），misdiagnosed rate is0%（0/304）4.OF all the304fetuses，six cases of fetal tricuspid regurgitation was found inthe first trimester of pregnancy (velocity>60m/s)，including3cases with majorstructural abnormalities terminationvof pregnancy，3cases of healthy birth. Conclusion:1.Nuchal translucency can be used for screening for fetal abnormalities in thefirst trimister of pregnancy.2.Standard anatomic NT ultrasound views can be used to defect some fetalmajor structural malformations efficiently,which has laid a good foundation forfurther examination or treatment.However ultrasound screening in early pregnancystill has some limitations，continuous scanning in different stages of pregnancy isnecessary. Part III Research on parameters of uterine artery blood flow in the firsttrimester of pregnancyObjective:To detect related parameters of uterine artery blood flow and characteristics ofDoppler in the first trimester of pregnancy，and to establish normal reference valuerange of bilateral uterine artery pulsatility index（PI）.Materials and methods:From October1，2013to October1，2014，a total of304pregnancies，referedto our institution for routine prenatal examination，were included in this cohort study.Useing prospective study， ultimately selected285cases of pregnant womenaccording to the inclusion and exclusion criteria.The left and right uterine arterieswere examined by color and pulsed Doppler and the mean pulse index（PI）as well asthe presence of a bilateral partly diastolic notch were recorded.Collect of data, use SPSS17.0statistical software package for statistical analysisand follow-up the pregnancy outcome.Result:1.Mean uterine artery PI decreased linearly with the increase of days the trend of pregnancy in the first trimester of pregnancy.2.In the trimester of pregnancy，83.8%of pregnant women have uterine arterynotch，62.8%is bilateral，21%is single.3.All of the31cases occur to adverse pregnancy outcome，in which hypertensivedisorders complicating pregnancy and GDM is each3.5%. The difference betweenpregnancy suffered from hypertensive disorder complicating pregnancy and healthypregnancy about bilateral uterine artery mean PI had no statistically significance (P>0.05). The difference between pregnancy suffered from GDM and healthy pregnancyabout bilateral uterine artery mean PI had no statistically significance (P>0.05).4.The difference between the manual measurement of uterine atery andmechanical measurement had statistically significance（P <0.05）.5.By the same method, measurement of pregnant women on the left and rightuterine artery PI, the difference between the left and right uterine artery PI hadstatistically significance （P <0.05）. The parameters of the uterine artery blood flowresistance of placental side and non-placental side PI had statistically significance (P <0.05).6.Left, resistance of blood flow parameters of uterine artery on the right side ofthe PI values were1.41+0.52,1.29+0.49. Placental side, non uterine arterialresistance placental side PI values were1.18+0.44,1.52+0.52.Conclusion:Mean uterine artery PI in the first trimester of pregnancy shows a significantlinear decrease.To estsblish the normal reference value range of PI，the characteristicsof early diastolic notch and studying the measurement of uterine artery Doppler ishelpful to further research the relevance between abnormal uterine artery blood flowand hypertensive disorders complicating pregnancy，FGR and poor pregnangcy finale.