产前超声筛查五步检查法在胎儿心脏畸形诊断中的应用价值

Application value of prenatal ultrasound screening five-step test method in the diagnosis of fetal cardiac malformations

目的分析产前超声筛查五步检查法在胎儿心脏畸形诊断中的应用价值。方法选取2020年1月至2021年12月我院收治的88例疑似怀有心脏畸形胎儿孕产妇为研究对象。所有研究对象均先接受常规产前超声筛查三步检查法检查,再接受产前超声筛查五步检查法检查。以分娩后新生儿心脏彩超或引产后胎儿尸检结果为金标准,比较两种检查方法的诊断效能及对不同类型胎儿心脏畸形的检出情况。结果金标准检查结果显示,88例疑似心脏畸形胎儿中,71例确诊为胎儿心脏畸形。产前超声筛查五步检查法在胎儿心脏畸形中的诊断准确度、灵敏度均高于常规产前超声筛查三步检查法(P<0.05);产前超声筛查五步检查法与常规产前超声筛查三步检查法在胎儿心脏畸形中的诊断特异度、阳性预测值、阴性预测值比较,差异无统计学意义(P>0.05)。产前超声筛查五步检查法对室间隔缺损、右心室肥大、心内膜垫缺损及心室发育不良综合征的鉴别准确率高于常规产前超声筛查三步检查法(P<0.05)。结论产前超声筛查五步检查法对胎儿心脏畸形的诊断效能较优,且能有效鉴别不同类型的胎儿心脏畸形,可作为胎儿心脏畸形的产前超声筛查手段,降低心脏畸形新生儿出生率。

Objective To analyze the application value of prenatal ultrasound screening five-step test method in the diagnosis of fetal cardiac malformations.Methods A total of 88 pregnant women with suspected cardiac malformations admitted in our hospital from January 2020 to December 2021 were selected as the research objects.All subjects received routine prenatal ultrasound screening three-step test method examination,and then received prenatal ultrasound screening five-step test method examination.The diagnostic efficacy of the two methods and the detection of different types of fetal cardiac malformations were compared with the results of neonatal echocardiography after delivery or fetal autopsy after induction of labor as the gold standard.Results The results of the gold standard examination showed that 71 of the 88 suspected fetal cardiac malformations were diagnosed as fetal cardiac malformations.The diagnostic accuracy and sensitivity of the prenatal ultrasound screening five-step test method in fetal cardiac malformations were higher than those of the routine prenatal ultrasound screening three-step test method(P<0.05);there were no significant differences in the diagnostic specificity,positive predictive value and negative predictive value between the prenatal ultrasound screening five-step test method and the routine prenatal ultrasound screening three-step test method in fetal cardiac malformations(P>0.05).The identification accuracy rate of prenatal ultrasound screening five-step test method for ventricular septal defect,right ventricular hypertrophy,endocardial cushion defect and ventricular dysplasia syndrome were higher than that of routine prenatal ultrasound screening three-step test method(P<0.05).Conclusion The prenatal ultrasound screening five-step test method has better diagnostic efficacy for fetal cardiac malformations,and can effectively identify different types of fetal cardiac malformations.It can be used as a prenatal ultrasound screening method for fetal cardiac malformations to reduce the birth rate of newborns with cardiac malformations.