产前超声诊断持续性右脐静脉的临床价值

打开文本图片集

ABSTRACTObjectiveTo diagnose persistent right umbilical vein（PRUV）byprenatal ultrasound，and toanalyze theassociationbetweenPRUVandfetalabnormalities.MethodsAtotalof183fetuseswithPRUVdiagnosedbyprenatal systematic ultrasound（PRUV group）and 4762 fetuses without PRUV（control group）in our hospital were enrolled.The diferencesin baselinedataof pregnant womenandfetuseswerecomparedbetwnthetwogroups.Thetypesofadditional abnormalitiesinfetuses withPRUVwereanalyzed.TheassociationbetweenPRUVandfetalabnormalitieswas exploredbycrosstabulationandLogisticregressonanalysis，andoddsratio（OR）wascalculatedtoassessthestrengthofaociatio.AllRUV fetuses were followedupfor1yearafterbirth toanalyze theiroutcomes.Thetypesof abnormalities inotherabnormal fetuses between non-isolated PRUVandabnormalities inthecontrol group were compared.The associationbetween PRUVand fetal abnormalitieswas exploredbyLgisticregresionanalysisafteradjustmentformateralage，estationalageatPRUVdiagosis， andhigh-riskfactors.ResultsTerewerenosignificantdiferencesinmateralage，aternalhighriskfactors，gestatioalage at PRUV diagnosis，fetal sex between the two groups.Among the 183 fetuses in the PRUV group，145 cases（ 79.23% ）were isolated PRUV and 38 cases（ 20.77% ）were non-isolated PRUV.Of the 38 non-isolated cases，24 cases（ 63.16% ）had cardiovascular abnormalities，10 cases （ 26.32% ）had single umbilical artery，and9 cases（ 23.68% ）had osseous abnormalities. The positive predictive values of PRUV foroverallfetal abnormalities and cardiovascular abnormalities were 20.77% and 13.11% respectively，and PRUV was significantly associated with the overall occurrence of fetal abnormalities（ OR =6.12， P <0.05） . Among the 183 PRUV fetuses，16 cases（ 8.74% ）had adverse pregnancy outcomes，and the incidence in non-isolated PRUV was 39.47% （15/38）.Subgroup analysis showed that compared with thecontrol group，there were significant diffrences inthe proportions ofcardiovascular abnormalitiesand singleumbilical artery innon-isolated PRUV fetuses （both P <0.05）. After adjustmentformaternalage，gestationalageatPRUVdiagnosis，andhigh-riskfactorsbyLogisticregresionanalysis，PRUV wassignificantlysociatedwithfetalcardiovascularabormalitiesandsingleumbilicalartery（OR=2.873，3.183，respectivel， both P

KEYWORDS Ultrasonography，prenatal;Persistent right umbilical vein;Adverse pregnancy outcomes; Comorbidity

持续性右脐静脉（persistentrightumbilical vein，PRUV）是一种常见的病理性脐血管残留畸形，属脐静脉发育异常范畴。（剩余8992字）