11~14周规范化超声筛查在胎儿心脏严重结构畸形中的应用

Application of Standardized Ultrasound Examination at 11-14 Weeks in Severe Structural Malformations of Fetal Heart

目的:探讨11~14周规范化超声筛查在胎儿心脏严重结构畸形中的应用价值。方法:回顾性选择2022年1月—2023年12月在九江市妇幼保健院进行早孕期超声检查的10000例孕妇,临床病例资料及超声影像学结果均齐全。统计早孕期规范化超声检查结果及随访结果,并分析早孕期规范化超声检查的诊断效能。结果:在本研究的10000例胎儿中,共30例存在心脏严重结构畸形;早孕期超声检查显示,40.00%(12/30)存在NT增厚,26.67%(8/30)存在DVa波反向,16.67%(5/30)存在三尖瓣返流(TR),共诊断25例胎儿存在心脏严重结构畸形,漏诊5例,检出率为83.33%(25/30)。以随访结果为金标准,早孕期胎儿规范化超声检查诊断心脏严重结构畸形的敏感度为83.33%,特异度为100%,准确率为99.95%,阳性预测值为100%,阴性预测值为99.95%,与随访结果高度一致。结论:早孕期规范化超声检查诊断胎儿心脏严重结构畸形的准确率较高,值得推广应用。

Objective:To investigate the application value of standardized ultrasound examination at 11-14 weeks in severe structural malformations of fetal heart.Method:A total of 10000 pregnant women who underwent ultrasound examination during early pregnancy in Jiujiang Maternal and Child Health Hospital from January 2022 to December 2023 were retrospectively selected,and the clinical case data and ultrasound imaging results were complete.The results of standardized ultrasound examination in early pregnancy and follow-up were analyzed,and the diagnostic efficacy of standardized ultrasound examination in early pregnancy was analyzed.Result:Of the 10000 fetuses in this study,30 had severe structural malformations of the heart.Ultrasonography during early pregnancy showed that 40.00%(12/30)had NT thickening,26.67%(8/30)had DVa wave reversal,and 16.67%(5/30)had tricuspid regurgitation(TR).A total of 25 fetuses were diagnosed with severe structural malformations of the heart,and 5 were missed,with a detection rate of 83.33%(25/30).Using follow-up results as the gold standard,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of standardized ultrasound examination for diagnosing severe cardiac structural abnormalities in early pregnancy fetuses were 83.33%,100%,99.95%,100%,and 99.95%,respectively,which were highly consistent with the follow-up results.Conclusion:The standardized ultrasound examination in early pregnancy has high accuracy in diagnosing severe structural malformations of fetal heart and is worthy of popularization and application.