产前超声诊断胎儿腹腔积液的临床意义

Clinical Significance of Prenatal Ultrasound Diagnosis of Fetal Peritoneal Effusion

摘要: 目的：总结产前胎儿腹腔积液的超声影像图像特征，探讨在产前进行胎儿腹腔积液超声诊断的临床价值。方法：对2021年5月至2024年5月在包钢集团第三职工医院(包头妇产医院)产前超声检出的35例腹腔积液胎儿的超声影像表现、合并异常及临床随诊结果进行总结分析。结果：35例腹腔积液的胎儿中早孕期检出4例(11.4%, 4/35)，中孕期检出15例(42.9%, 15/35)，晚孕期检出16例(45.7%, 16/35)。35例腹腔积液胎儿声像图均表现为腹腔内探及游离液性无回声区，其中孤立性腹腔积液8例(22.9%, 8/35)，合并1种或多种其他异常的胎儿22例(77.1%, 22/35)，包括消化系统异常22例(62.9%, 22/35)，胸腔积液10例(28.6%, 11/35)，心脏异常9例(25.7%, 9/35)，泌尿系统异常6例(17.1%, 6/35)，神经系统异常5例(14.3%, 5/35)，颈部淋巴水囊瘤2例(5.7%, 2/35)，颜面部异常2例(5.7%, 2/35)，双胎输血2例(5.7%, 2/35)，其他异常20例(57.1%，20/35，心包积液、羊水过多或过少等)。结论：产前超声检查是检出胎儿腹腔积液的首选检查方法，能够在产前发现胎儿腹腔积液及合并异常，同时进行定期随访，对指导临床诊断及治疗有重要意义。

Abstract: Objective: To summarize the characteristics of prenatal ultrasound images of fetal peritoneal effusion, and to explore the clinical value of prenatal ultrasound diagnosis of fetal peritoneal effusion. Methods: From May 2021 to May 2024, the ultrasonographic manifestations, complications and clinical follow-up results of 35 fetuses with ascites detected by prenatal ultrasound in the Third Staff Hospital of Baotou Group (Baotou Maternity Hospital) were summarized and analyzed. Results: Among 35 fetuses with ascites, 4 cases (11.4%, 4/35) were detected in early pregnancy, 15 cases (42.9%, 15/35) in middle pregnancy and 16 cases (45.7%, 16/35) in late pregnancy. The ultrasonographic images of 35 fetuses with ascites showed abdominal cavity and free fluid anechoic area, including 8 cases (22.9%, 8/35) with isolated ascites and 22 cases (77.1%, 22/35) with one or more other abnormalities, including digestive system abnormalities in 22 cases (62.9%, 22/35), pleural effusion in 10 cases (28.6%, 11/35), cardiac abnormalities in 9 cases (25.7%, 9/35), urinary system abnormalities in 6 cases (17.1%, 6/35), and nervous system abnormalities in 5 cases (14.3%, 5/35), twin transfusion in 2 cases (5.7%, 2/35), other abnormalities in 20 cases (57.1%, 20/35, pericardial effusion, oligohydramnios, etc.). Conclusion: Prenatal ultrasound is the first choice to detect fetal peritoneal effusion, which can find fetal peritoneal effusion and its complications before delivery, and regular follow-up is of great significance to guide clinical diagnosis and treatment.