产前超声在胎儿先天性心脏病筛查中的应用

Application of Prenatal Ultrasound in the Screening of Fetal Congenital Heart Disease

目的:探究产前超声在胎儿先天性心脏病筛查中的应用效果。方法:选取2016年4月—2017年5月于我院接受常规产前检查的孕妇1496例,采用VulsonE8超声诊断仪对孕妇进行检查。将引产后胎儿尸检结果或新生儿心脏超声检查结果作为金标准,分析超声筛查情况及应用价值。结果:1496例孕妇中引产后胎儿尸检结果或新生儿心脏超声检查共检出48例胎儿存在先天性心脏病,发生率为3.21%;产前经超声筛查共检出42例,漏诊6例,检出率为2.81%,漏诊类型包括主动脉弓缩窄2例,室间隔缺损4例,心脏超声筛查胎儿先天性心脏病准确率为87.50%。超声在诊断胎儿先天性心脏病中灵敏度为75.00%,特异度为99.59%,准确度为98.80%,阳性预测值为85.71%,阴性预测值为99.17%。结论:产前超声在胎儿先天性心脏病筛查中应用价值显著,可将其作为筛查疾病的首选方式,对提高出生质量、促进优生优育具有重要作用。

Objective:To explore the effect of prenatal ultrasound in the screening of fetal congenital heart disease.Methods:From April 2016 to May 2017,1496 pregnant women who received routine prenatal examinations in our hospital were selected and examined by VulsonE8 ultrasound diagnostic equipment.The results of postnatal fetal autopsy or neonatal cardiac ultrasound examination were used as the gold standard to analyze the status and application value of ultrasound screening.Results:Among 1496 pregnant women,48 cases of fetuses with congenital heart disease were detected in postpartum fetal autopsy results or neonatal cardiac ultrasound,the incidence rate was 3.21%;42 cases were detected by prenatal ultrasound screening,and 6 cases were missed The detection rate was 2.81%.The types of missed diagnosis included 2 cases of aortic arch constriction and 4 cases of ventricular septal defect.The accuracy rate of cardiac ultrasound screening for fetal congenital heart disease was 87.50%.In the diagnosis of fetal congenital heart disease,ultrasound has a sensitivity of 75.00%,a specificity of 99.59%,an accuracy of 98.80%,a positive predictive value of 85.71%,and a negative predictive value of 99.17%.Conclusion:Prenatal ultrasound is of great value in the screening of fetal congenital heart disease.It can be used as the first choice for screening diseases,and plays an important role in improving birth quality and promoting eugenics.