超声检测静脉导管对孕11-14周胎儿先天性心脏畸形的诊断价值

Diagnostic value of fetal congenital heart defects on pregnant 11-14 weeks by ultrasonic examination of venous catheter

目的探讨超声检测静脉导管对孕11-14周胎儿先天性心脏畸形的诊断价值。方法对孕11-14周的1800例胎儿检测静脉导管频谱及血流参数,并与胎儿先天性心脏畸形的相关性进行分析。结果胎儿正常组(1785例)与胎儿先天性心脏畸形(室间隔缺损、大动脉转位、单心室、永存动脉干)组(15例)相比,阻力参数S/D、PI、PLI、PVIV明显增高,血流参数S、D、A、TAmax无明显差异;以静脉导管频谱及血流参数任意符合一项异常都视为静脉导管异常,分为正常胎儿组与静脉导管异常胎儿组,静脉导管异常组与胎儿先天性心脏畸形有明显相关性。结论孕11-14周胎儿超声检测静脉导管,能在相对较早的时间检出胎儿先天性心脏畸形,可在产前诊断中心广泛开展,对非产前诊断中心特别是基层医院进行必要的培训后也可作为胎儿先天性心脏畸形的筛查方法,以提高胎儿期先心病的检出率。

Objective To investigate the clinical value of ultrasonic examination of venous catheter in diagnosis of fetal congenital heart defects during 11-14 weeks of pregnancy. Methods The fetal venous catheter spectrum and blood flow parameters were measured in 1800 fetuses at 11-14 weeks of gestation, and the correlation between congenital anom- alies and fetal congenital heart malformations was analyzed. Results Compared with fetal abnormalities of congenital heart anomalies, such as ventricular septal defect, transposition of the great arteries, single ventricle and permanent arte- rial trunk, Parameters S / D, PI, PLI and PVIV increased significantly. The blood flow parameters S, D, A and TAmax had no significant difference. The venous catheter spectrum and blood flow parameters in line with an exception are con- sidered abnormal venous catheter, fetal group and abnormal vein catheter group, abnormal catheter group and fetal con- genital heart malformations were significantly correlated. Conclusion Fetal venous catheter examination during 11-14 weeks of gestation can detect fetal congenital heart defects at a relatively early time. It is widely carried out in the prenatal diagnosis center. It is essential for non-prenatal diagnosis center, especially in primary hospital.