胎儿心脏畸形的超声筛查和诊断模式的临床评估

A clinical evaluation of the prenatal screening mode of fetal cardiac anatomy by ultrasound

目的:分析重庆医科大学附属第一医院产前诊断中心2005年2月至2008年12月胎儿心脏畸形诊断及漏诊情况,对我院目前的胎儿心脏超声筛查和诊断模式进行临床评估。方法:妊娠20～24周在我院行产科系统超声检查并在本院分娩的胎儿9685例,随访胎儿预后。胎儿心脏超声筛查切面包括四腔心切面、左右心室流出道切面。胎儿心脏的超声诊断是在以上切面的基础上更多切面的检查。计算不同切面的敏感性和特异性。结果:9685例胎儿中,产前诊断胎儿心脏畸形46例,漏诊5例。四腔心切面诊断的敏感性为58.82%,特异性为99.98%。四腔心切面结合流出道切面的敏感性为86.27%,特异性为99.98%。结论:四腔心结合流出道切面对心脏畸形的宫内诊断有较高的敏感性和特异性,是诊断胎儿先天性心脏病的首选方法。目前的胎儿心脏畸形的筛查和诊断模式可较全面地了解胎儿心脏结构,发现异常率高。临床上切实可行,易于推广。

Objective： The objective of this study was to assess prenatal heart screening program by uhasound in our hospital. Methods ： 20-24 weeks gestation screening scans were performed on 9 685 women.Follow-up data of fetuses was obstained by us.Fetal heart screening was based on four-chamber and outflow tract views. Results： Among 9 685 cases,46 cases of fetal cardiovascular abnormality were found, 5 cases were false negative.The sensitivity of the four-chamber view alone was 58.82%,The sensitivity of the combination of the four-chamber and outflow tract views was 86.27%.the specificity was 99.98%. Conclusion： The screening program showed good sensi- tivity and excellent specificity.Our prenatal heart screening progaram was feasible.