早孕期超声心动图检查在先天性心脏病临床诊断中的应用价值

Application value of echocardiography in the clinical diagnosis of congenital heart disease in early pregnancy

目的分析早孕期超声心动图检查在先天性心脏病临床诊断中的应用价值。方法回顾性选取我院2015年1月至2021年1月收治的100例单胎初产妇的临床资料进行分析,均进行超声心动图检查。以终止妊娠后尸检结果或出生后确诊情况为金标准,分析超声心动图对先天性心脏病的诊断效能;总结典型病例的影像学特征;分析先天性心脏病患儿的血流动力学指标。结果100例孕妇中,检出14例先天性心脏病,2例误诊,1例漏诊。超声心动图诊断先天性心脏病的灵敏度为93.33%,特异度为97.65%,阳性预测值为87.50%,阴性预测值为98.81%,准确度为97.00%。先天性心脏病患儿的二尖瓣口血流峰值、三尖瓣口血流峰值、肺动脉瓣口血流峰值高于正常新生儿,差异具有统计学意义(P<0.05)。结论早孕期超声心动图检查在先天性心脏病临床诊断中的应用价值较高,值得临床推广应用。

Objective To analyze the application value of echocardiography in the clinical diagnosis of congenital heart disease in early pregnancy.Methods The clinical data of 100 primiparas with singleton fetus admitted in our hospital from January 2015 to January 2021 were retrospectively selected and analyzed.All of them underwent echocardiography.The diagnostic efficacy of echocardiography for congenital heart disease was analyzed by taking the autopsy results after termination of pregnancy or the diagnosis after birth as the gold standard;the imaging features of typical cases were summarized;the hemodynamic parameters of children with congenital heart disease was analyzed.Results Among 100 pregnant women,14 cases of congenital heart disease were detected,2 cases were misdiagnosed and 1 case was missed.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of echocardiography in the diagnosis of congenital heart disease were 93.33%,97.65%,87.50%,98.81% and 97.00%,respectively.The peak flow at mitral valve orifice,peak flow at tricuspid valve orifice and peak flow at pulmonary valve orifice in children with congenital heart disease were higher than those in normal neonates,and the differences were statistically significant(P<0.05).Conclusion Echocardiography in early pregnancy has a high value in the clinical diagnosis of congenital heart disease,which is worthy of clinical promotion and application.