经阴道超声筛查11-14周NT增厚胎儿心脏畸形的应用价值

目的探讨使用经阴道超声的检查方法,对NT（颈项透明层）增厚的11-14周胎儿进行心脏畸形筛查的应用价值。方法对2011年1月—2014年3月在该院超声检查发现NT增厚（NT〉2.5 mm）的11-14周的胎儿,分别进行经腹部、经阴道超声检查胎儿心脏结构,对比两者的显示率,并将经阴道检查的结果与比引产后病理或20-24周胎儿超声心动图或生后超声心动图结果进行对比。结果经阴道检查心脏各切面的显示率均高于经腹部检查,差异有统计学意义（P〈0.05）;102例NT增厚的胎儿中,经阴道检查检出心脏畸形9例,全部与随访结果相符,诊断符合率100%。结论经阴道超声检查与胎儿NT检查同时进行,可大大提前NT增厚胎儿心脏畸形的检出时间,经阴道超声对于早期诊断胎儿先天性心脏畸形具有重要的临床应用价值。

Application Value of Transvaginal Ultrasound Screening for Cardiac Malfor-mation in Fetuses of 11 ~14 Weeks' Gestation with Increased Nuchal Translucency

Objective To study the application value of transvaginal ultrasound screening for cardiac malformation in fetuses of11-14 weeks＇ gestation with increased NT（nuchal translucency）. Methods The fetuses of 11-14 weeks＇ gestation who were found with increased nuchal translucency（NT〉2.5mm） by ultrasonic examination in our hospital from 2011 January to 2014 March, underwent cardiac scan by transabdominal and transvaginal ultrasonography, and the display rates of them were compared. The result of transvaginal ultrasonography was compared with that of the pathological examination after induced labor or echocardiogram of fetuses of 20 -24 weeks＇ gestation or postnatal echocardiogram. Results The display rate in each section by transvaginal ultrasonography was much higher than that by transabdominal ultrasonography, the difference was statistically significant（P〈0.05）. Of the 102 fetuses with increased NT who were studied, malformation of heart was detected in 9 cases by transvaginal ultrasonography, the results were accorded with the follow-up result, the diagnostic accordance rate was 100%. Conclusion Transvaginal ultrasound combined with fetal NT examination can detect the heart malformationion in fetuses with increased NT much earlier. And transvaginal ultrasound has important clinical application value in the early diagnosis of fetal congenital heart malformation.