| 高倩倩,罗红.2012—2022年产前超声诊断先天性肾脏和尿路畸形[J].中国医学影像技术,2023,39(12):1764~1769 |
| 2012—2022年产前超声诊断先天性肾脏和尿路畸形 |
| Prenatal ultrasonic diagnosis of congenital anomalies of kidney and urinary tract during 2012-2022 |
| 投稿时间：2023-08-13 修订日期：2023-10-21 |
| DOI：10.13929/j.issn.1003-3289.2023.12.002 |
| 中文关键词: 胎儿 泌尿系疾病 超声检查,产前 |
| 英文关键词:fetus urologic diseases ultrasonography, prenatal |
| 基金项目: |
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| 中文摘要: |
| 目的 对比2012—2022年我国二孩、三孩政策实施前、后产前超声诊断胎儿先天性肾脏和尿路畸形（CAKUT）的准确率及妊娠结局。方法 回顾性分析政策前组53 857名单胎妊娠孕妇（含158胎CAKUT）及政策后组167 627名单胎孕妇（含521胎CAKUT），观察组间胎儿CAKUT发病率、产前超声诊断CAKUT准确率及胎儿出生率的差异。结果 政策后组CAKUT发病率0.31%（521/167 627），政策前组为0.29%（158/53 857），前者高于后者（P>0.05）。政策后组CAKUT孕妇年龄大于政策前组[（29.2±4.6）岁vs.（27.0±4.3）岁，P<0.05]，而产前超声诊断CAKUT孕周小于政策前组[（25.3±7.3）周vs.（27.8±7.1）周，P<0.05]。组间产前超声诊断CAKUT准确率，诊断胎儿上尿路相关异常、下尿路相关异常及单纯CAKUT准确率差异均无统计学意义（P均>0.05）。2组胎儿CAKUT均以肾外泌尿系统异常占比最高。产前超声诊断政策后组合并其他系统异常胎儿CAKUT准确率（92.54%vs.84.29%）及后尿道瓣膜形成准确率均高于政策前组（100%vs.50.00%，P均<0.05）。全部679胎CAKUT胎儿中，143胎终止妊娠，536胎继续妊娠。组间CAKUT胎儿出生率，以及上尿路相关异常、下尿路相关异常及合并其他系统异常CAKUT胎儿出生率差异均无统计学意义（P均>0.05）；政策后组单纯CAKUT胎儿出生率高于政策前组（97.61%vs.93.18%，P<0.05）。结论 实施二孩、三孩政策后，我国产前超声诊断CAKUT孕周提前、准确率提高，单纯CAKUT胎儿出生率增加。 |
| 英文摘要: |
| Objective To compare the accuracy of prenatal ultrasonic diagnosis for congenital anomalies of the kidney and urinary tract (CAKUT) as well as pregnancy outcomes before and after implementation of the two-child and three-child policy in China during 2012-2022. Methods Data of 53 857 pregnant women with 158 CAKUT fetuses in pre-policy group, and 167 627 pregnant women with 521 CAKUT fetuses in post-policy group were retrospectively analyzed. The incidence rate of fetal CAKUT, the accuracy of prenatal ultrasonic diagnosis and the birth rate of CAKUT were compared groups. Results The incidence rate of fetal CAKUT was 0.31% (521/167 627) in post-policy group and 0.29% (158/53 857) in pre-policy group, in the former was lower than in the latter (P>0.05). Pregnant women with CAKUT fetus in post-policy group was older than in pre-policy group ([29.2±4.6] years vs. [27.0±4.3] years, P<0.05), while prenatal ultrasonic diagnosis of CAKUT in post-policy group was earlier than in pre-policy group ([25.3±7.3] weeks vs. [27.8±7.1] weeks, P<0.05). No significant difference of diagnostic accuracy of prenatal ultrasound of CAKUT, of upper urinary tract related abnormalities, lower urinary tract related abnormalities nor single CAKUT was found between groups (all P>0.05). The proportion of extra-renal urinary system abnormalities was the highest in both groups. The accuracy of prenatal ultrasound diagnosis of other system abnormalities in post-policy group was lower than that in pre-policy group (all P<0.05). The accuracy of prenatal ultrasonic diagnosis of posterior urethral valve formation in post-policy group was higher than that in pre-policy group (100% vs. 50.00%, P<0.05), but no significant difference of other abnormal manifestations was detected between groups (all P>0.05). Terminate pregnancy occurred in 143 fetuses with CAKUT, while other 536 fetuses continued pregnancy. There was no significant difference of the birth rate of CAKUT fetuses with upper urinary tract related abnormalities, lower urinary tract related abnormalities nor other system abnormalities between groups (all P>0.05). The birth rate fetuses with single CAKUT in post-policy group was higher than that in pre-policy group (97.61% vs. 93.18%, P<0.05). Conclusion With the implementation of two-child and three-child policy of China, the average prenatal ultrasonic diagnosis of CAKUT became earlier, the accuracy of prenatal ultrasonic diagnosis of CAKUT and the birth rate of fetus with single CAKUT increased. |
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