复合超声心动图筛查孕早期胎儿先天心脏病的应用价值

Application value of compound echocardiography in screening fetal congenital heart disease in early pregnancy

目的:采用复合超声心动图在孕早期对胎儿心脏进行检查,并结合跟踪随访或尸体解剖结果评估其在胎儿先天心脏病筛查中的应用价值。方法:选取2019年3月-2020年10月于本院进行胎儿心脏病筛查的孕早期孕妇进行研究,共对3458例胎儿进行心脏检查,根据是否具备先天心脏病高危因素将胎儿分为高危组(n=1032)与低危组(n=2426)。将先天心脏病胎儿跟踪随访结果或引产后尸体解剖结果与筛查结果进行对照,分析复合超声心动图检查的准确率,与高危因素对胎儿先天心脏病的影响。结果:产前超声诊断胎儿先天心脏病57例,检出比例1.65%(57/3458)。其中有筛查高危因素胎儿35例3.39%(35/1032),无筛查高危因素胎儿22例0.91%(22/2426),高危组胎儿先天心脏病检出率显著高于低危组(P<0.05)。共获随访55例,其中7例继续妊娠,产后行超声心动图检查证实;另48例引产尸解证实。结论:复合超声心动图具有安全性高、操作简便等优势,对胎儿先天心脏病检出精准度高,适用于孕早期胎儿心脏检查。

Objective:To evaluate the application value of compound echocardiography in fetal congenital heart disease screening in combination with the results of follow-up or autopsy in early pregnancy.Methods:A total of 3458 fetuses with heart disease screening in our hospital from March 2019 to October 2020 were selected for this study,and according to whether they had the risk factors of congenital heart disease,the fetuses were divided into high risk group(n=1032)and low risk group(n=2426).The follow-up results of fetuses with congenital heart disease or autopsy results after labor induction were compared with the screening results to analyze the accuracy of complex echocardiography and the influence of high risk factors on fetuses with congenital heart disease.Results:57 cases of fetal congenital heart disease were diagnosed by prenatal ultrasound,and the detection rate was 1.65%(57/3458).There were 3.39%(35/1032)fetuses with screening high-risk factors,and 0.91%(22/2426)fetuses without screening high-risk factors.The detection rate of congenital heart disease in the high-risk group was significantly higher than that in the low-risk group(P<0.05).A total of 55 patients were followed up,7 of whom continued pregnancy and were confirmed by postpartum echocardiography,another 48 cases of induced labor were confirmed by autopsy.Conclusion:Complex echocardiography has the advantages of high safety,simple operation,high accuracy in fetal congenital heart disease detection,and was suitable for fetal heart examination in early pregnancy.