胎儿超声心动图在胎儿先天性心脏病产前诊断中的临床价值

摘要

Objective To investigate the value of fetal echocardiography (F-Echo) in prenatal diagnosis of congenital heart disease (CHD) in fetus. Methods Pregnant women with high risk and longer than 16 weeks of gestation time were selected to fetal echocardiography. The following views should be paid more attention in examination:transverse view of fetal upper abdomen, fetal four chamber view, fetal left and right ventricular outflow tracts views, fetal short axis view of great artery as well as aortic arch view. Results 9 cases of fetal CHD were detected with fetal echocardiography, 7 complex congenital heart disease, 1 ventricular sepal defect and 1 tetrology of Fallot diagnosed after parturition. The sensitivity and specificity of fetal echocardiography were 82.9% and 100% respectively. Conclusion Fetal echocardiography is a valuable tool in diagnosing congenital heart disease in fetus, but its accuracy is influenced by some factors including pregnant women body style, fetal positions and examiner's experiments etc.%目的探讨胎儿超声心动图在产前诊断胎儿先天性心脏病的临床意义。方法选择妊娠16周, 分娩前有高危倾向的孕妇310例行胎儿超声心动图检查。检查中着重观察胎儿腹部切面、胎儿四腔心切面、胎儿左右室流出道长轴或大动脉短轴切面、胎儿主动脉弓长轴切面。结果共发现9例先天性心脏病胎儿，其中复杂先天性心脏病7例、单纯室间隔缺损1例、1例出生前未确诊，出生后诊断为法洛四联症。敏感性82%，特异性100%。结论胎儿超声心动图是早期诊断胎儿畸形，评价胎儿心功能的有用工具。其诊断的准确性受孕妇体形、胎儿体位以及检查者的经验积累等多方面因素的影响。