目的：本研究旨在证明孕中期肛门闭锁超声筛查的表现，并描述初级保健胎儿医学诊所的相关经验。
方法：我们回顾性分析了2019年11月至2022年5月在太极诊所接受孕中期筛查的胎儿的病历。进行Fisher精确检验以调查潜在的危险因素。
结果：在研究期间，我们的诊所筛查了28.459例胎儿；最终，6例出生后诊断为肛门闭锁。我们样本中肛门闭锁的发生率为2.11/10.000。根据我们的发现,与肛门闭锁显著相关的潜在危险因素包括:多胎妊娠(p值=0.0185)和体外受精(p值=0.038).一半的肛门闭锁病例与影响其他器官系统的异常有关，最常见的是泌尿生殖系统（66.7％）和心血管系统（66.7％），尤其是持续性左上腔静脉(2例)。
结论：肛门闭锁是一种需要广泛护理的畸形；产前发现其体征后的临床处理应包括检测染色体异常和密切监测羊水量。因此,产前超声筛查在妊娠中期肛门闭锁至关重要，特别是在多胎妊娠和试管婴儿妊娠的情况下，和多种异常。具有肛门闭锁超声迹象的胎儿应在妊娠后期随访，并转诊至专门机构进行产后管理计划和父母咨询。
OBJECTIVE: The
study aimed to demonstrate the performance of anal atresia ultrasound screening in the second trimester and to describe associated experiences in a primary care fetal medicine clinic.
METHODS: We retrospectively analyzed the medical records of fetuses who underwent a second-trimester screening at the Taiji clinic between November 2019 and May 2022. Fisher\'s exact test was conducted to investigate potential risk factors.
RESULTS: There were 28 459 fetuses screened in our clinic during the
study period; eventually, 6 cases were diagnosed with anal atresia after birth. The incidence of anal atresia in our sample was 2.11 in 10 000. Based on our findings, potential risk factors significantly associated with anal atresia included: multiple pregnancies (p-value = 0.0185) and in-vitro fertilization (p-value = 0.038). Half of the anal atresia cases were associated with abnormalities affecting other organ systems, most frequently the genitourinary system (66.7%) and cardiovascular system (66.7%), especially persistent left superior vena cava (2 cases).
CONCLUSIONS: Anal atresia is a malformation that requires extensive care; the clinical management after the prenatal discovery of its signs should include testing for chromosomal abnormalities and close monitoring of the amniotic fluid volume. Therefore, prenatal ultrasound screening for anal atresia in the second trimester is critical, particularly in the cases of multiple and IVF pregnancies, and multiple abnormalities. The fetuses with ultrasound signs of anal atresia should be followed at a later gestational period and referred to a specialized institution for postnatal management planning and parental counseling.
