产前超声筛查胎儿先天性心脏病的临床应用研究

Screening of fetal congenital heart disease by prenatal echocardiography

目的:探讨胎儿超声心动图(FECG)产前筛查胎儿先天性心脏病(CHD)的临床应用价值。方法:采用四腔心、左室流出道、右室流出道、三血管切面'四切面法'对4 200例孕20~41周孕妇进行产前FECG筛查,以引产后尸解或产后新生儿ECG作为对照标准。结果:4 200例胎儿中,经引产或产后证实的各种CHD 43例,四切面检出CHD 41例,其中37例经证实为CHD,敏感性86.05%(37/43),漏诊6例,误诊4例。结论:四切面检查方法简便可靠,是显示胎儿心脏结构及产前筛查胎儿CHD的重要影像诊断方法。

Objective:To evaluate the effectiveness of fetal echocardiography for the screening of fetal congenital heart disease(CHD).Methods: 4 200 consecutive pregnant women with gestational age of 20 to 41 weeks underwent echocardiographic screening for fetal congenital heart disease using four-view method,an integration of four-chamber view,left ventricular outflow tract view,right ventricular outflow tract view and three-vessel view.The results were compared with those of fetus autopsy from induced abortion and neonatal echocardiography.Results: In all 4 200 fetus,43 had congenital heart disease confirmed by fetus autopsy from induced abortion and neonatal echocardiography.By using the four-view method,congenital heart disease was diagnosed in 41 fetus,of which 37 had confirmed abnormalities and 4 had normal hearts.Six fetus with CHD were not detected by this method,and diagnostic errors occurred in 4 fetus.The sensitivity of the method was 86.05%(37/43),and the specificity was 99.90%(4 153/4 157).Conclusion: The four-view method is a simple and effective method to detect the structural abnormality of fetal heart,which has great clinical significance for prenatal screening of fetal congenital heart disease.