基层医院开展胎儿超声心动图筛查的作用分析

Analysis on the role of fetal echocardiography screening in primary hospitals

目的:探讨基层医院开展胎儿超声心动图筛查的作用。方法:选取2017年1月—2019年6月在北京市昌平区妇幼保健院建档并进行胎儿超声心动图筛查的孕妇10763例,其中10117例产后行新生儿超声心动图筛查,对产前检查出心脏异常病例转诊,与产前诊断机构诊断结果、生后新生儿超声心动图筛查结果、尸检及手术结果进行对比,并对常规扫查切面进行回顾性分析、讨论。结果:经产前超声心动图5切面法筛查出胎儿心脏异常共136例,确诊134例,诊断准确率98.5%(134/136),检出率1.2%(134/10763),漏诊1例,为完全型肺静脉异位引流。误诊2例,1例主动脉弓曲折误诊为主动脉弓离断;1例正常心脏误诊为主动脉缩窄。结论:基层医院常规开展规范化胎儿超声心动图筛查,对及早发现并诊断先天性心脏病具有重要的临床价值。

Objective To explore the role of the development of fetal echocardiography screening in primary hospitals.Methods 10,763 pregnant women who were filed at the Maternal and Child Health Hospital of Changping District,Beijing and conducted fetal echocardiography screening were selected from January 2017 to June 2019.Among them,10,117 newborns conducted fetal echocardiography screening after delivery,cases with heart abnormalities detected before delivery were referred,the diagnosis results of diagnosis institutions before delivery,the results of echocardiography screening of newborns after delivery,autopsy and surgery results were compared,and routine scanning sections were retrospectively analyzed and discussed.Results A total of 136 cases with fetal heart abnormalities were screened by the prenatal echocardiogram 5 section method,134 cases were diagnosed,the diagnostic accuracy rate was 98.5%(134/136),and the detection rate was 1.2%(134/10763).One case was missed,which was total anomalous pulmonary venous drainage.Two cases were misdiagnosed,1 case of aortic arch tortuosity was misdiagnosed as aortic arch interruption;One case of normal heart was misdiagnosed as aortic coarctation.Conclusion Routine standardized fetal echocardiographic screening in primary hospitals has important clinical value for the early detection and diagnosis of congenital heart disease.