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首页> 外文期刊>Prenatal Diagnosis >Ultrasound in prenatal diagnosis: polemics around routine ultrasound screening for second trimester fetal malformations.
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Ultrasound in prenatal diagnosis: polemics around routine ultrasound screening for second trimester fetal malformations.

机译：产前诊断中的超声检查：围绕常规超声筛查妊娠中期胎儿畸形的争论。

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摘要

Ultrasound for routine fetal malformation screening has been polemical from its early beginning because of the very broad range of diagnosis rates disclosed, i.e. from 13% to 82%, average 27.5%. A review of available studies is proposed to assess objectively the efficacy of ultrasound, considering also economical, ethical and methodological aspects as influential factors for choosing a routine screening policy. The utility of fetal malformation diagnosis before birth is brought forward, including second opinion, karyotyping, poly-disciplinary case discussion prior to management. Method and material of reviewed studies considerably vary and might influence the sensitivity results, as the choice of the population sample and selection of pregnant women, gestation age at screening, distribution of malformation among systems or tracts, exclusion of some fetal malformation and the routine practice of autopsy. Efficiency of screening studies is compared, and among them Radius and Eurofetus studies. Average sensitivity is finally considered as satisfactory in the daily practice when operated by trained personnel. The importance of additional factors for successful screening are emphasized such as education, equipment quality and fetal ultrasound examination at different gestation age for a better understanding of natural history of fetal morphology.
机译：由于所揭示的诊断率范围非常广泛，即从13％到82％，平均为27.5％，用于常规胎儿畸形筛查的超声技术从一开始就颇具争议。建议对现有研究进行回顾，以客观地评估超声的功效，同时还将经济，伦理和方法学方面作为选择常规筛查策略的影响因素。提出了出生前胎儿畸形诊断的实用性，包括第二意见，染色体核型分型，在治疗前进行多学科病例讨论。回顾研究的方法和材料千差万别，可能会影响敏感性结果，因为人群样本的选择和孕妇的选择，筛查的胎龄，系统或道段中畸形的分布，某些胎儿畸形的排除和常规做法尸检。比较了筛选研究的效率，其中包括Radius和Eurofetus研究。当由受过训练的人员操作时，平均灵敏度最终被认为是在日常实践中令人满意的。强调了其他因素对成功筛查的重要性，例如教育程度，设备质量和不同胎龄的胎儿超声检查，以便更好地了解胎儿形态的自然史。

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