產前超聲診斷胎兒生殖系統異常的臨床證據_《中國循證醫學雜志》

作者：

唐英 ,  羅紅

四川大學華西第二醫院超聲科（成都 610041）;

關鍵詞：

超聲檢查胎兒畸形生殖系統臨床證據

DOI：

10.7507/1672-2531.20090244

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目的　探討產前超聲篩查胎兒生殖系統異常是否可行。
方法　計算機檢索Cochrane 圖書館（2009 年第2 期）、MEDLINE（1981 ～ 2009）、OVID ACP Journal Club（1991 ～ 2009）和BMJ Clinical Evidence（1999 ～ 2009），尋找相關的系統評價、隨機對照試驗、隊列研究、臨床對照試驗。
結果　檢索到隊列研究5 個、橫斷面研究3 個。結果顯示：超聲觀察早孕期（孕11 ～ 14 周）胎兒臀部泌尿生殖結節線指向、泌尿生殖結節線與胎兒腰骶部皮膚水平線夾角確定胎兒性別可行，孕周越大確定胎兒性別準確率越高。女性胎兒子宮及男性胎兒陰莖、陰囊隨著孕周增加而長大，絕大多數男性胎兒在出生前睪丸已降至陰囊。產前超聲發現胎兒生殖器官異常可作為篩查指標之一，聯合羊水中激素檢查可早期診斷某些胎兒生殖器官異常、胎兒性分化異常、胎兒內分泌代謝異常、胎兒染色體異常相關疾病。
結論　產前超聲診斷胎兒生殖系統異常可行，但不能發現全部生殖系統異常，是否成為產前超聲常規篩查項目還需高質量的隨機對照研究進一步證實。

引用本文： 唐英,羅紅. 產前超聲診斷胎兒生殖系統異常的臨床證據. 中國循證醫學雜志, 2009, 09(12): 1343-1345. doi: 10.7507/1672-2531.20090244 復制

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3.	Efrat Z, Perri T, Ramati E, et al. Fetal gender assignment by firsttrimester ultrasound. Ultrasound Obstet Gynecol, 2006, 27: 619-621.
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7.	Phyllis G, Shalini U, Koff D, et al. Fetal sex assignment by sonographic evaluation of the pelvic organs in the second and third trimester of pregnancy. Ultrasound Med, 2007, 26: 563-569.
8.	Oritpinhas H, Yaron Z, Eric S, et al. Prenatal Diagnosis of Sex Differentiation Disorders: The Role of Fetal Ultrasound. The Journal of Clinical Endocrinology & Metabolism, 2002, 87(10): 4547-4553.
9.	Mazza V, Di Monte I, Pati M, et al. Sonographic biometrical range of external genital differentiation in the first trimester of pregnancy analysis of 2593 cases. Prenat Diagn, 2004, 24: 677-684.

1. Phillips B, Ball C, Sackett D, et al. Levels of evidence and grades of recommendation. Available for URL: http://www.cebm.net.
2. Natsuyama E. Sonographic determination of fetal sex from twelve weeks of gestation. Am J Obstet Gynecol, 1984, 149: 748-757.
3. Efrat Z, Perri T, Ramati E, et al. Fetal gender assignment by firsttrimester ultrasound. Ultrasound Obstet Gynecol, 2006, 27: 619-621.
4. Soriano D, Lipitz S, Seidman DS, et al. Development of the fetal uterus between 19 and 38 weeks of gestation: in utero ultrasonographic measurements. Human Reprod, 1998, 14: 215-218.
5. Zalel Y, Pinhas-Hamiel O, Lipitz S, et al. The development of the fetal penis–an in uteru sonographic evaluation. Ultrasound Obstet Gynecol, 2001, 17: 129-131.
6. Achiron R, Pinhas-Hamiel O, Zalel Y, et al. Development of fetal male gender: prenatal sonographic measurement of thescrotum and evaluation of testicular descent. Ultrasound Obstet Gynecol, 1998, 11: 242-245.
7. Phyllis G, Shalini U, Koff D, et al. Fetal sex assignment by sonographic evaluation of the pelvic organs in the second and third trimester of pregnancy. Ultrasound Med, 2007, 26: 563-569.
8. Oritpinhas H, Yaron Z, Eric S, et al. Prenatal Diagnosis of Sex Differentiation Disorders: The Role of Fetal Ultrasound. The Journal of Clinical Endocrinology & Metabolism, 2002, 87(10): 4547-4553.
9. Mazza V, Di Monte I, Pati M, et al. Sonographic biometrical range of external genital differentiation in the first trimester of pregnancy analysis of 2593 cases. Prenat Diagn, 2004, 24: 677-684.

《中國循證醫學雜志》

產前超聲診斷胎兒生殖系統異常的臨床證據

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《中國循證醫學雜志》

產前超聲診斷胎兒生殖系統異常的臨床證據

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