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Prenatal diagnosis of congenital fetal heart abnormalities and clinical analysis*

机译:先天性胎儿心脏异常的产前诊断和临床分析*

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摘要

Objective: To study the value of detecting fetal congenital heart disease (CHD) using the five transverse planes technique of fetal echocardiography. Methods: Nine hundred and eighty-two high-risk pregnancies for fetal CHD were included in this study, the fetal heart was scanned with the five transverse planes technique of fetal echocardiography described by Yagel, autopsy was conducted when pregnancy was terminated. Blood from fetal heart was collected for fetal chromosome analysis. A close follow-up was given for normal fetal heart pregnancies and neonatal echocardiography was performed to check the accuracy of prenatal diagnosis. Results: (1) Forty-six cases (4.68%) were found to have fetal heart abnormalities in this study, 69.56% of them were diagnosed by single four-chamber view, another 30.43% fetal CHD were found by combining other views; (2) Forty-one parents of prenatal fetuses with CHD chose to terminate pregnancy, thirty-two of them gave consent to conduct autopsy, 93.75% of which yielded unanimous conclusion between prenatal fetal echocardiography and autopsy; (3) Thirty-two of 46 cases underwent fetal chromosome analysis, 8 cases (25%) were found to have abnormal chromosome; (4) Five cases were found to have right ventricle and atrium a little bigger than those on the left side, with the unequal condition being the same after birth, but there were no clinical manifestations and they are healthy for the time being; (5) Nine hundred and thirty-six cases were not found with abnormality in this study, but one case was diagnosed with ventricular septal defect after birth, one case was diagnosed with patent ductus arteriosus, one case had atrial septal defect after birth. Conclusions: (1) The detected CHD rate was 4.68% by screening fetal heart with five transverse planes according to Yagel’s description of high risk population basis for CHD. The coinciding rate of prenatal diagnosis and autopsy was 93.75%; (2) The sensitivity of detecting fetal heart abnormality is 92%, the specificity is 99.6% using the five transverse planes technique of fetal echocardiography; (3) Fetuses with mild or moderate disproportion of right and left side in the heart are potentially healthy babies.
机译:目的:研究利用胎儿超声心动图的五个横平面技术检测胎儿先天性心脏病(CHD)的价值。方法:本研究纳入了982例胎儿冠心病高危妊娠,采用Yagel描述的胎儿超声心动图的五种横断面技术对胎儿心脏进行了扫描,并在终止妊娠时进行了尸检。从胎儿心脏收集血液用于胎儿染色体分析。对正常的胎儿心脏妊娠进行了密切随访,并进行了新生儿超声心动图检查,以检查产前诊断的准确性。结果:(1)本研究发现46例(4.68%)胎儿心脏异常,其中单腔四腔检查诊断为69.56%,其他方法合并胎儿CHD检出率为30.43%; (2)有41名CHD胎儿父母选择终止妊娠,其中32名同意进行尸检,其中93.75%的结果在胎儿超声心动图和尸检之间取得了一致的结论; (3)对46例中的32例进行了胎儿染色体分析,发现8例(25%)染色体异常; (4)发现5例右心室和心房比左侧大,出生后不平等,但无临床表现,暂时健康。 (5)本研究未发现963例异常,但出生后诊断为室间隔缺损1例,动脉导管未闭确诊为1例,出生后存在房间隔缺损为1例。结论:(1)根据Yagel对高危人群CHD的描述,通过五个横断面筛查胎儿心脏,发现CHD率为4.68%。产前诊断与尸检的符合率为93.75%; (2)采用胎儿超声心动图的五横平面技术检测胎儿心脏异常的敏感性为92%,特异性为99.6%; (3)心脏左右两侧轻度或中度不对称的胎儿可能是健康的婴儿。

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