四腔心切面加流出道切面在产前筛查先天性心脏病中的临床价值

Clinical significances of four-chamber view and ventricular outflow tract view for prenatal screening of congenital heart diseases

目的:探讨胎儿心脏四腔心切面加左、右室流出道切面在产前筛查胎儿先天性心脏病中的临床价值。方法:采用彩色多普勒超声对5 184例孕20周以上孕妇常规进行胎儿心脏四腔切面加左、右室流出道切面进行检测,发现胎儿心脏异常者,由专人做完整的、多切面胎儿心动图检查,提示客观的超声诊断,并与产后彩色多普勒超声检查及转送上级产前诊断中心进行超声检查的随访结果对照。结果:产前检出胎儿先天性心脏病27例,检出率为5.21‰(27/5 184),产后彩色多普勒超声证实10例,产前诊断中心检查后证实17例。产前检查无异常的胎儿中,产后发现胎儿先天性心脏病3例。结论:胎儿心脏四腔切面加左、右室流出道切面能显示绝大多数胎儿先天性心脏病的直接或间接的异常声像图表现,对产前筛查胎儿先天性心脏病具有重要临床应用价值。其探测方法简单、所需时间较短、且易于掌握、便于临床推广应用。

Objective： To explore the clinical significances of fetal four - chamber view, left and right ventficular outflow tract views for prenatal screening of fetal congenital heart diseases. Methods： A total of 5 184 pregnant women more than 20 gestational weeks were selected and their fetal four - chamber view, left and fight ventricular outflow tract views received color uhrasonography, the cases with fetal abnormalities received intact fetal cardiogram with multiple views, then objective ultrasonic diagnosis was obtained, and the results were compared with the results of postpartum color ultrasonography and ultrasonic results of further prenatal diagnostic center during follow - up. Results： A total of 27 cases with fetal congenital heart diseases were found by prenatal uhrasonography, the detection rate was 5.21‰ （27/5 184）, 10 eases were diagnosed by postpartum color uhrasonography, and 17 cases were diagnosed by prenatal diagnostic center; a- mong the fetuses without abnormalities during prenatal examination, 3 cases were found with fetal congenital heart diseases after birth. Conclusion： Fetal four - chamber view, left and fight ventricular outflow tract views can reveal direct and indirect abnormal ultrasonic manifestations of most fetuses with congenital heart diseases, which have important clinical application values for prenatal screening of con- genital heart diseases, the methods are simple, and the time is short, which is easy to be grasped and worthy to be popularized in clinic.