Application of Four-Dimensional Ultrasound in Prenatal Screening of Fetal Limb Deformities

TAN Mengwei; ZHOU Wenbo; SUN Ning

doi:10.3639/j.issn.2095-3097.2024.11.015

Abstract：Objective To explore the application value of four-dimensional ultrasound in prenatal screening of fetal limb malformations.Methods Clinical and imaging data of 1,865 pregnant women who received prenatal screening for fetal malformations at Changzhou Maternal and Child Health Hospital from January 2022 to December 2023 were retrospectively collected.All pregnant women underwent routine two-dimensional ultrasound and four-dimensional ultrasound,with neonatal malformations or actual delivery after labor induction as the gold standard.The value of routine two-dimensional ultrasound and four-dimensional ultrasound in diagnosing fetal limb malformations was compared.Results In 1,865 pregnant wom-en,16 cases(0.86%)of fetal limb malformations were detected,6 cases were confirmed by labor induction and 10 cases were confirmed after delivery.A total of 9 cases of limb deformities were diagnosed by prenatal routine two-dimensional ultrasound,and the agreement with autopsy or postnatal examination results was moderate(Kappa value=0.433).A total of 14 cases of limb deformities were diagnosed by prenatal four-dimensional ultrasound,which showed good agreement with the results of autop-sy or post-delivery examination(Kappa value=0.715).The sensitivity,specificity,and accuracy of prenatal screening for fetal limb malformations by routine two-dimensional ultrasound were 56.25%,99.14%,and 98.77%,respectively.The sensitivi-ty,specificity,and accuracy of prenatal screening for fetal limb malformations by four-dimensional ultrasound were 87.50%,99.51%,and 99.41%,respectively.The area under the curve(AUC)of four-dimensional ultrasound for prenatal screening of fetal limb malformations was higher than that of routine two-dimensional ultrasound(0.777 vs 0.935,Z=3.862,P<0.05)..Conclusion Four-dimensional ultrasound has higher value than routine two-dimensional ultrasound in prenatal screening for fetal limb malformations and can reduce the risk of misdiagnosis.