超声心脏五横切面产前筛查胎儿心脏畸形的效果

Effect of ultrasound heart five short axis view screening on fetal prenatal cardiac malformation

目的探讨超声心脏五横切面产前筛查胎儿心脏畸形的效果。方法选取2014年1月至2018年5月在洛阳市妇女儿童医疗保健中心进行产前检查的6500例产妇,采用心脏五横切面检测法对胎儿产前心脏畸形情况进行检查,统计各心脏畸形类型,并与分娩后检查及尸检结果进行比较,同时比较心脏五横切面检测法与单独采用四腔心切面检查结果。结果经五横切面筛查,6500例产妇中共检出心脏畸形胎儿40例(0.615%)。妊娠结果:继续妊娠并分娩20例,引产19例,胎儿死亡1例,根据产后检查及尸检结果与五横切面筛查检测结果,其筛查存在5例漏诊及3例误诊情况,其阴性预测值为99.92%,阳性预测值为90.00%;特异性为99.94%,敏感性为87.80%,且其敏感性显著高于单独采用四腔心切面检查结果(P<0.05),而其特异性虽与单独采用四腔心切面检查结果比较差异未见统计学意义(P>0.05),但仍略高于单独采用四腔心切面检查结果,另外采用五横切面筛查,其误诊率及漏诊率分别为0.06%及0.07%,均显著优于四腔心切面检查结果(P<0.05)。结论采用超声心脏五横切面筛查对胎儿产前心脏畸形情况进行筛查,其结果较为准确,能够为临床诊断及治疗提供较为理想的参考,值得推广使用。

Objective To investigate the effect of ultrasound heart five short axis view screening on fetal prenatal cardiac malformation. Methods A total of 6 500 women who underwent prenatal examination in Luoyang Women’s and Children’s Medical and Health Care Center from January 2014 to May 2018 were enrolled. The heart five short axis view test was used to check the fetal prenatal cardiac malformation. The types of cardiac malformations were counted and compared with the results of post-partum examination and autopsy were compared, and the results of the five-section test of the heart and the four-chamber view of the heart were compared. Results Through five short axis view screening, a total of 40 cases of fetal cardiac malformation in 6 500 parturients (0.615%). The result of the pregnancy showed that: 20 cases of continued pregnancy and delivery, 19 cases of induced labor, and 1 case of fetal death. Postpartum examination and autopsy results were compared with the results of five short axis view screening tests, it was found that there were 5 cases of missed diagnosis and 3 cases of misdiagnosis. The negative predictive value was 99.92%, and the positive predictive value was 90.00%. The sensitivity was 99.94%, and the sensitivity was 87.80%, and the sensitivity was significantly higher than that of the four-chamber view alone(P<0.05), the specificity had no significant difference between the two methods (P>0.05), but it was still slightly higher than the results of the four-chamber view alone. The misdiagnosis rate and the missed diagnosis rate of five short axis view screening were 0.06% and 0.07%, which were significantly better than the four-chamber view alone (P<0.05). Conclusions Ultrasound heart five short axis view screening is used to screen prenatal fetal malformations. The results are more accurate and can provide an ideal reference for clinical diagnosis and treatment. It is worthy of popularization.