超声心动图诊断胎儿期动脉导管依赖型先天性心脏病的价值

Value in diagnosis of fetus ductal-dependent congenital heart disease by echocardiography

目的探讨超声心动图对胎儿期动脉导管依赖型先天性心脏病的诊断价值。方法选择超声诊断为胎儿期动脉导管依赖型先天性心脏病孕妇15例,年龄21~45岁,平均年龄28.7岁;孕周20~36周,平均孕周29.0周。行产前胎儿、生后婴儿超声心动图,对引产胎儿行病理解剖检查。分析胎儿期、生后婴儿超声心动图表现,并与病理解剖结果对照。结果 15例动脉导管依赖型先天性心脏病胎儿,其中Ⅰ型8例,Ⅱ型5例,Ⅲ型2例。14例引产,其中12例病理解剖检查证实为动脉导管依赖型先天性心脏病,2例未行病理解剖检查。1例正常分娩,产前误诊为主动脉弓缩窄,产后超声证实为主动脉弓离断。引产后经病理检查证实12例与超声诊断结果一致,超声诊断正确率85.7%。结论超声心动图作为一种可靠方法,对产前诊断胎儿期动脉导管依赖型先天性心脏病具有重要价值,可指导临床优生选择和产后及时救治。

Objective To evaluate the value of echocardiography in diagnosis of ductal-dependent congenital heart disease.Methods A total of 15 pregnant women with fetus ductal-dependent congenital heart disease by echocardiography were enrolled, which aged 21-45 years old with mean age of 28.7 years old, the gestational aged 20-36 weeks with mean of 29.0 weeks. The prenatal fetal and postnatal infant echocardiographies were performed, then analyzed and compared with the results of pathological anatomy. Results The 15 ductal-dependent congenital heart disease were diagnosed by fetal echocardiography, which included 8 cases of type Ⅰ, 5 of type Ⅱ and 2 of type Ⅲ. The 14 cases were performed induced labor, and 12 cases, 12 of which pathological anatomy confirmed arterial catheter-dependent congenital heart disease, and 2 without patho-logical anatomy. One case was delivered normally, which prenatal misdiagnosed as aortic arch constriction and postpartum ul-trasound confirmed interruption of aortic arch. All the 12 cases were consistent with the results of ultrasound diagnosis by pathology after induction of labor. The ultrasound diagnosis accuracy rate was of 85.7 %. Conclusion Echocardiography is a reliable method and plays an important role in prenatal diagnosis of fetus ductal-dependent congenital heart disease, so it is significance for guiding clinical decision-making and timely postnatal treatment.