二维超声在胎儿先心病筛查中的应用

目的 探讨二维超声在胎儿先天性心脏病筛查中的应用，提高胎儿先天性心脏病的检出率。方法 以四腔心，左室长轴及心底短轴为主要切面，对3825例孕18周以上胎儿心脏进行初步筛查，并随访在本院分娩的新生儿，证实有先天性心脏病者，追踪其母孕期超声检查结果，对比先天性心脏病类型。结果 共检出心脏畸形8例，检出率0．21％。其中心内膜垫缺损2例，右室双出口1例，功能单心室1例，左室发育不良2例，室间隔缺损2例。其中6例为复杂重症先心病，占75％。2例室间隔缺损均大于6mm，并伴有心外畸形。结论 二维超声对胎儿心脏进行常规初步筛查，能够发现大多数胎儿心脏畸形，可作为初步筛查复杂先心病的方法。

Application of two-dimensional ultrasound in screening for fetal congenital heart disease

Objective To evaluate the application of two-dimension ultrasound in the screening for fetal congenital heart disease(CHD). Methods (1)The position of heart, the size of atrium and ventricle chambers, the atrioventricular septum and the atrioventricular valves were observed on the four-chamber view.(2): The position and crossing relationship of aorta and pulmonary artery, and the size of their calibers were shown on the short-axis view. (3): The consecution of ventricular septum and aorta were observed on the left ventricle long-axis view. The neonates whose hearts had murmur were checked by echocardiogram. If CHD was found, we traced the ultrasound result during pregnancy and conformed the type of CHD. Result In the routine prenatal examination by 2D ultrasound we chose the four-chambers, Left ventricle long-axis and Short-axis view as the primal views. Of 3825 fetuses that were beyond 18 weeks, we found eight heart malformations (0.21%). Two heart intima cushions defect, one right ventricular double outlet, one functional single ventricular, two left ventricular dysphasia, and two ventricular septal defects. Of them six cases were complex severe congenital heart diseases, heart ventricular septal defect of two cases was over 6 mm and there were other deformations. Conclusion Two-dimensional ultrasound is a method of conventionally initial screening for fetal heart and can discover most fetal heart deformations.