胎儿心脏畸形诊断中产前超声应用的价值及准确率分析

Value and Accuracy Analysis of Prenatal Ultrasound in the Diagnosis of Fetal Heart Malformations

目的探产前超声检查用于胎儿心脏畸形中的诊断价值。方法选择2019年1月至2019年12月于我院进行产前检查的孕妇1000例,均开展产前超声诊断,分析胎心心脏畸形检出情况,并与产后随访记录进行对比,评估超声诊断的价值。结果经随后随访检查发现78例胎儿心脏畸形,占比为7.8%,其中包括室间隔缺损18例、复杂性先天性心脏病13例、双上腔静脉9例、右锁骨下动脉迷走7例、心内膜垫缺损6例、主动脉弓狭缩5例、大动脉转位4例、左锁骨下动迷走3例、法洛四联症3例和左房无回声、右脐静脉、室间隔膨胀瘤、永存动脉干、永存左上腔、双主动脉弓、单心室、肺动脉狭窄、肺静脉异位引流、横纹肌瘤各1例;超声检查共计检出胎儿心脏畸形75例,检出率为7.5%;超声检查结果对比产后随访结果,差异无统计学意义(P>0.05);超声检查有3例发生漏诊,其中2例为室间隔缺损,1例为主-肺动脉窗;统计超声检查准确率为96.15%(75/78)。结论产前超声检查对胎儿心脏畸形诊断具有显著价值,准确率较高,且快速、无创、可重复,以便于尽早发现胎儿心脏畸形,及时干预,以降低胎儿出生缺陷的发生,提高出生人口质量。

Objective To explore the diagnostic value of prenatal ultrasound in fetal heart malformation.Methods 1000 pregnant women who underwent antenatal examination in our hospital from January 2019 to December 2019 were selected to carry out prenatal ultrasound diagnosis,analyze the detection of fetal heart and heart malformations,and compare them with postpartum follow-up records to evaluate the value of ultrasound diagnosis.Results 78 cases of fetal heart malformations were found after follow-up examination,accounting for 7.8%,including 18 cases of ventricular septal defect,13 cases of complex congenital heart disease,9 cases of double superior vena cava,7 cases of right subclavian artery vagus,6 cases of endocardial pad defect,5 cases of aortic arch constriction,4 cases of great artery transposition,3 cases of left subclavian artery vagus,3 cases of tetralogy of Fallot,3 cases of left atrial echo,right umbilical vein,ventricular septal dilation tumor Permanent left superior chamber,double aortic arch,single ventricle,pulmonary artery stenosis,anomalous pulmonary vein drainage and rhabdomyoma in 1 case each;75 cases of fetal heart malformations were detected by ultrasonography,the detection rate was 7.5%;There was no significant difference between the results of ultrasonography and those of postpartum follow-up(P>0.05);There were 3 cases of missed diagnosis by ultrasonography,including 2 cases of ventricular septal defect and 1 case of main pulmonary artery window;The accuracy of ultrasonic examination was 96.15%(75/78).Conclusion Prenatal ultrasound examination has significant value in the diagnosis of fetal heart malformation,with high accuracy,rapid,non-invasive and repeatable,so as to find fetal heart malformation as soon as possible and intervene in time,so as to reduce the occurrence of fetal birth defects and improve the quality of the birth population.