四腔心切面联合三血管气管切面彩色多普勒超声在孕11~13^(+6)周胎儿严重先天性心脏畸形筛查中的应用价值

Clinical application of four-chamber view combined with three-vessel and trachea view color Doppler in screening severe congenital heart malformations in fetuses at 11-13^(+6)weeks of gestation

目的探讨四腔心切面联合三血管气管切面彩色多普勒超声在孕11~13^(+6)周胎儿严重先天性心脏畸形筛查中的应用价值。方法选择2018年1月至12月在四川省妇幼保健院行孕期检查的9756例孕妇,分别于孕11~13^(+6)周及孕16~24周进行胎儿心脏超声检查。采用四腔心切面联合三血管气管切面彩色多普勒超声对孕11~13^(+6)周胎儿筛查心脏畸形,采用标准化胎儿超声心动图筛查孕16~24周胎儿心脏畸形,并对分娩后所有新生儿及引产胎儿进行随访。结果9756例胎儿孕11~13^(+6)周超声筛查发现心脏畸形38例(51.4%,38/74),其中非严重心脏畸形5例(14.2%,5/35),严重心脏畸形33例(84.6%,33/39)。出生或引产后诊断先天性心脏畸形74例,其中严重先天性心脏畸形39例,非严重心脏畸形35例。结论运用四腔心切面联合三血管气管切面彩色多普勒超声能筛查出大部分严重胎儿心脏畸形,可为临床咨询、预后提供及时有力的证据。

Objective To investigate the clinical value of four-chamber view combined with three-vessel and trachea(3VT)view color Doppler in screening severe congenital heart malformation in fetuses at 11-13^(+6)weeks of gestation.Methods From January to December 2018,9756 pregnant women underwent ultrasound examination at their gestational weeks of 11-13^(+6)and 16-24,respectively.Four-chamber view combined with 3VT view color Doppler was used to screen fetal cardiac malformations at 11-13^(+6)weeks of gestation.The standardized method of fetal echocardiography was performed at 16-24 weeks of gestation.All neonates and induced fetuses were followed after delivery.Results A total of 74 congenital heart malformations were found among the 9756 pregnant women,including 39 severe congenital heart malformations and 35 non-severe cardiac malformations.Thirty-eight(51.4%,38/74)congenital heart malformations were found at 11-13^(+6)weeks of gestation,including 5 non-severe cardiac malformations(14.2%,5/35),33 severe congenital heart malformations(84.6%,33/39).Conclusion Most serious fetal heart malformations can be detected when using four-chamber view combined with 3VT view color Doppler,which can provide strong evidence for clinical consultation and prognosis.