84例胎儿心脏畸形的超声心动图诊断与分析

目的总结分析84例胎儿先天性心脏畸形的超声心动图特征，旨在帮助提高基层对胎儿心脏畸形的认识而减少误诊。方法回顾性分析自1992-2006年1月发现的84例心脏畸形胎儿的超声心动图主要诊断特征和重要切面。结果部分病例与尸检结果和出生后超声检查对照，心脏异常胎儿超声诊断符合率100％，绝大部分先天性心脏病畸形可在胎儿期获得明确诊断。复杂心脏畸形如单心房、单心室、完全型心内膜垫缺损、右室双出口等占全部病例的90．5％，均被终止妊娠，一般畸形仅占9．5％。78．5％胎儿在25周以后才被发现心脏异常。观察部分型心内膜垫缺损11周胎儿的十字交叉结构明显受限。结论胎儿超声心动图检查是非常有用的工具，能诊断绝大部分先天性心脏畸形，特别是复杂畸形。应当将胎儿超声心动图检查纳入常规工作和建立标准化扫查常规。

The Echocardiographic Diagnosis and Analysis of Fetal Cardiac Malformation of 84 Cases

Objective To summerize and analyse the echocardiographic charicteristic points of fetal congenital cardiac malformation of 84 cases. Hopefully, this method can be helpful for understanding this kind of disease and avoiding misdiagnosis. Methods Restrospectively analyse the main echocardiographic points of fetal congenital cardiac malformation in 84 cases in our hospital from 1992 to January, 2006. Results There were compared between before and after birth or autopsy in some cases. All the diagnosis of echocardiography were proven consistent with those of the after-birth tests and artopsy. The results in this research, 90.5% cases were complicated malformation, for example ,single atrium, single ventricle, complete atrioventricular canal defect, double-outle ventricle, et al. All the pregnancy in these cases were ended. Only 9.5% cases were generic malformation. Mostly, congnital cardiac malformation could be diagnosed definitely in fetal stage.78.5% cases were discoverd abnormal after 25 weeks. The decussation structure was observed restricted in the 11th week of partial forms of atrioventricular canal defect. Conclusion Fetal echocardiography is clearly essential to diagnose most part of congnital cardiac malformation, especially the complicated cases. According to its importance, this method is supposed as one of the routine tests and the standard procedure should be founded.