彩色多普勒超声筛查中孕期胎儿心脏畸形的临床价值

Clinical significance of color Doppler ultrasound on fetal cardiac malformation screening in the mid trimester of pregnancy

目的探讨彩色多普勒超声筛查中孕期胎儿心脏畸形的临床价值。方法应用彩色多普勒超声对3210例18-24周的胎儿心脏进行筛查,分别观察四腔心切面、左室流出道切面、右室流出道切面、三血管气管切面,检出心脏畸形时加上主动脉弓切面、导管弓切面及腹部横切面。结果共筛查出胎儿心脏畸形30例,其中室间隔缺损10例,法洛四联症5例,左心发育不良5例,右心发育不良2例,单心房1例,心内膜垫缺损3例,主动脉缩窄1例,主动脉弓离断1例,三尖瓣下移畸形1例,右室双出口1例,所有畸形均经引产尸检或产后超声检查证实。结论应用彩色多普勒超声,采用四腔心切面联合左右室流出道切面、三血管气管切面可以筛查大部分中孕期胎儿心脏畸形,对降低新生儿死亡率提高新生儿生存质量有重要临床价值。

Objective To evaluate the clinical significance of color malformation screening in the mid trimester of pregnancy. Methods Doppler ultrasound on fetal cardiac A total of 3 210 fetal hearts between 18 and 24 gestational weeks were examined by color Doppler ultrasound. Four chamber view, left ventricular outflow tract view, right ventricular outflow tract view and 3-vessels-trachea view were observed. Aortic arch view,ductus arteriosus view and abdominal transverse plane were further examined in the case of cardiac malformation. Results A total of 30 cases of cardiac malformations were confirmed by ultrasound screening, including 10 ventricular septal defect, 5 tetralogy of fallot, 5 hypoplastic left heart syndrome, 2 right ventrieular dysplasia, 1 single atrium, 3 endocardial cushion defect, 1 coarctation of aorta, 1 interruption of aortic arch, 1 Ebstein＇s anomaly, and 1 double outlet of right ventricle. All the cases were confirmed by odinopoeia or postnatal ultrasound examination. Conclusion Most fetal cardiac malformations in the mid trimester of pregnancy can be screened out by the four chamber, left ventricular outflow tract, right ventricular outflow tract, and 3-vessels-trachea views of Color Doppler Ultrasound, which is of significant clinical value to decrease neonatal mortality and improve tile quality.