11~14周正常胎儿心脏超声检查

目的对妊娠11^＋0～14^＋6周正常胎儿心脏结构进行观察，获得该孕周内正常胎儿心脏的生理参数。方法对100位孕妇在妊娠11^＋0～14^＋6周进行常规经腹超声检查，同时观察胎儿心脏各切面结构并进行测量。结果胎儿心脏各切面显示率不同，四腔心显示率最高，其次是动脉交叉，而动脉导管的显示率最低。妊娠13周以后胎儿心脏结构超声可清晰显示。胎儿心脏周长、面积及各心室内径的增加与孕周有相关性，而心脏周长与胸廓周长比值，心脏面积与胸廓面积比值，左右心房比值以及房室率均相对衡定，与孕周之间无明显相关性。结论由于在妊娠13周以后胎儿心脏结构能够清晰显示，因此，可以将胎儿超声心动图检查时间提前至妊娠中期的早期。主要筛查与四腔心切面相关的严重的胎儿先天性心脏畸形，有利于胎儿严重先天性心脏畸形的早期诊断。

Fetal echocardiography in normal fetuses between 11 and 14 gestational age

Objective To observe the cardiac structures of the normal fetuses between 11+0 to 14+6 weeks' gestation for obtaining the normative data of the gestational age. Methods There were 100 pregnant women had a general examination by transabdominal ultrasonography between 11+0 and 14+6 gestational weeks. At the same time, the fetal cardiac structures had been observed and measured. Results The percentage of cardiac structures visualized differ in different planes. In these planes, the four-chamber view has the highest rate of visualization, the crossing arteries lower, and the ducttus arteriosus has a poor rate of visualization. The fetal cardiac structures can be visualized clearly after 13 gestational weeks. The increasing of the fetal cardiac circumference, area, and the interior diameters of bilateral ventricular correlated with the gestational age. The ratios of cardiac to thoracic circumference and area, the left atria to right atria ratio, and the atrial-to-ventricular length ratio are relatively invariable, there was no obvious correlation between these ratios and the gestational age. Conclusion Because of the fetal cardiac structures can be visualized significantly after 13 weeks' gestation, the fetal echocardiography examination could be used during the early second-trimesters of pregnancy. The severe congenital heart defects involving the four-chamber view could be diagnosed at this period. The fetal echocardiography examination in the early second-trimester is helpful for the early diagnosis of the severe congenital cardiac defects.