胎儿心脏畸形在高危与低危孕妇中超声检出率的研究

目的 通过比较胎儿心脏畸形在高危与低危孕妇人群中的超声检出率,为制定胎儿心脏超声筛查的策略提供依据.方法 将7165例受检孕妇分为高危组(2147例)和低危组(5018例).以四腔心、左右室流出道为主要筛查切面,对疑有异常者行详细超声心动图检查.统计分析两组胎儿心脏畸形的超声检出率以及有关危险因素的分布.结果 共检出胎儿心脏畸形95例(1.33%),其中高危组检出32例(1.49%),高龄妊娠位居高危因素的第一位.低危组检出63例(1.26%).高危组与低危组孕妇其胎儿心脏畸形的超声检出率比较差异无统计学意义(X2=0.635,P=0.426).对23例心脏畸形胎儿进行了脐血或羊水穿刺染色体检查,其中染色体异常11例(47.83%).结论 胎儿心脏畸形在高危与低危人群中的超声检出率相近,应提倡对所有胎儿行心脏超声筛查,以便在产前尽早发现胎儿严重的心脏畸形.

Routine fetal screening for congenital heart diseases: the detection rate in the high-risk and low-risk population

Objective To provide basis for routine fetal cardiac screening by comparing the ultrasound detection rate of fetal heart defects between the high-risk and low-risk population.Methods According to the questionnaire about maternal risk factors,all 7165 pregnant women were divided into two groups.The high-risk group included 2147 cases and the remained 5018 were considered as low-risk population.Routine fetal heart screening was performed by the four-chamber view,left and right outflow tract views.If some cardiac malformations were found,the detailed fetal echocardiography would be performed.Both the detection rate of fetal cardiac defects and distribution of the relevant risk factors were analyzed.Results Ninty-five(1.33%)cases of congenital heart disease were found in our study,32(1.49%)cases from highrisk group and 63(1.26%)cases from low-risk group.No significant was found between the two groups (X2=0.635,P＞0.05).Karyotyping were performed prenatally in 23 of 95 fetal congenital defects cases by cordocentesis and chorionbiopsy,and 11(47.83%)cases of concomitant chromosomal abnormality were found.Conclusions Routine fetal screening for congenital fetal diseases should be performed in non-selected population for the similar detection rate of fetal defect in high-risk and low-risk group.