超声检测胎儿严重先天性心脏畸形9例分析

Analysis of 9 Cases of Serious Congenital Fetal Heart Malformation Diagnosed by Echocardiography

目的探讨二维超声心动图和彩色多普勒超声产前诊断胎儿先天性心脏畸形的可行性。方法应用二维超声图像对胎儿心脏进行四腔切面、左室流出道、右室流出道切面等心脏解剖结构检查，加以彩色多普勒血流图对胎儿心脏进行血流方向及流速的观察。结果１３５３９例被检孕妇中９例胎儿存在严重的先天性畸形，其中４例左心发育不良，２例肺动脉瓣狭窄，２例大血管转位，１例内脏反位、右心发育不全，均由病理尸解或新生儿心脏超声证实。其中由超声检查确诊５例，误诊１例，漏诊３例。结论超声产前诊断部分胎儿先天性心脏畸形是可行的，且可间接降低围产儿病死率。

Objective To investigate whether congenital fetal heart malformation could be diagnosed with two-dimensional doppler echocardiography before delivery. Methods The anatomical structures of fetal heart were observed using cross-sectional imaging,including the position in throax,4-chamber view,aortic outflow tract and pulmonary outflow tract.The direction and velocity of blood flow of fetal heart were obseved with doppler echocardiography. Results 9 cases of serious congenital fetal heart malformation in 13539 pregnancies were diagnosed with echocardiography.Among them were 4 cases of left ventricular hypoplasia,2 cases of pulmonic valve stenosis,2 cases of great arterious transposition,1 cases of right ventricular hypoplasia with situs inversus(mirror image dextrocardia),all confirmed by pathological autopsy or neonatal echocardiography.After sonographical examination,5 cases were correctly diagnosed, 1 case misdiagnosed and 3 cases failed to be diagnosed. ConclusionUsing two-dimensional doppler echocardiography to diagnose partial serious congenital fetal heart malformation is feasible.It will help to reduce the motality of perinatal newborn.