胎儿先天性心脏病的产前诊断

Prenatal diagnosis of perinatal congenital heart disease

目的:探讨胎儿先天性心脏病(先心病)发生趋势、危险因素及其产前诊断情况,为早期筛查、诊断及预防提供依据。方法:选择2006～2008年间分娩的活产儿、死胎、死产和治疗性引产儿,进行先心病相关因素分析。结果:3年间共分娩38282例,发现先心病193例,35岁以上高龄孕妇胎儿先心病发生率明显增加。经过系统产检者诊断孕周为(26.86±5.32)周,较未系统产检者明显提前。合并胎儿发育受限、单脐动脉、染色体异常、其他器官发育异常者胎儿先心病发生率也较其他组明显增加。结论:孕前宣教先心病知识,孕期系统产检,特别对有高危因素的孕妇加强监测,必要时行胎儿超声心动图检查,做到早期筛查、诊断及干预,以减少先心病的发生及其不良预后,提高人口素质。

Objective：To investigate trends in epidemiology,risk factors and prenatal diagnosis of perinatal congenital heart disease （CHD）,in order to provide scientific evidence for prophase screening and taking preventive measures.Methods：From January 2006 to December 2008,CHD and its related factors were monitored in all the patients,who were born in our hospital,including live-births,dead foetus,dead birth and remedial induced deliveries.Results：A total of 193 cases of CHD were detected in 38 282 fetals.The prevalence rates of perinatal CHD for maternal age groups over 35 years old were remarkably higher than those under 35 years old.The diagnosis time of perinatal CHD for the patients who were examinated systematic during pregnancy were （26.86 ± 5.32） week,advanced than those no examination.The prevalence rates of perinatal CHD of the patients combined fetal growth restrict,single umbilical arteries,chromosome abnormality and other organs abnormal formation were remarkably higher than others.Conclusion：Paying attention to intervention before and during maternal pregnancy,performing prenatal diagnosis as early as possible and for gravidas with high-risk factors and improving diagnostic level of fetal echocardiography examination,which are key to improve early diagnosis of CHD,to enhance quality of population,and improve the qualities of life of children.