产前超声诊断先天性心脏病合并心外畸形的应用及对优生优育的指导价值

目的探讨产前超声诊断应用于先天心脏病合并心外畸形的临床价值及对优生优育的指导价值。方法选取2017年5月~2018年5月于我院接受产前超声诊断结果异常的132例孕妇作为主要研究对象,所有孕妇均接受产前超声诊断,并产后随访6个月,分析其CHD及合并心外畸形的类型,以及产前超声诊断的临床价值。结果132例参与研究的孕妇中,随访成功108例,随访率为81.82%。随访成功的108例孕妇中,共检出24例CHD胎儿,产前超声诊断检出21例,诊断准确率为87.50%,漏诊率为12.50%。19例仅引产后尸体解剖检查证实为CHD,5例经出生后超声复查证实为CHD。24例CHD胎儿中,单纯先天性心脏病13例,其中4例完全性大动脉移位、3例左心发育不良、1例法洛四联症、5例完全性心内膜垫缺损,合并心外畸形11例,其中1例三尖瓣下移畸形合并肾积水,肺囊腺癌、7例室间隔缺损合并肾积水,内腔反位,脐膨出、1例法洛四联症合并羊水少,脊柱侧弯、1例永存左上腔静脉合并肾积水、1例右室双出口合并马蹄内翻足。对11例CHD合并心外畸形的胎儿进行随访,其中10例选择引产,1例室间隔缺损合并肾积水,内腔反位,脐膨出的孕妇选择继续妊娠,产后随访妊娠结果与产前超声诊断结果基本相同。结论产前超声诊断应用于先天性心脏病合并心外畸形胎儿的临床价值较高,且对优生优育具有一定的指导作用。

Application of prenatal ultrasound in the diagnosis of congenital heart disease complicated with extracardiac malformation and its guiding value for prenatal and postnatal care

Objective:To investigate the clinical value of prenatal ultrasound diagnosis in congenital heart disease complicated with extracardiac malformation and its guiding value for prenatal and postnatal care.Methods:A total of 132 pregnant women who underwent prenatal ultrasound diagnosis in our hospital from May 2017 to May 2018 were selected as the main subjects.All pregnant women were diagnosed with prenatal ultrasound and followed up for 6 months after delivery to analyze their CHD.And the type of extracardiac malformation,as well as the clinical value of prenatal ultrasound diagnosis.Results:Of the 132 pregnant women who participated in the study,108 were followed up successfully,and the follow-up rate was 81.82%.Among the 108 pregnant women who were successfully followed up,24 CHD fetuses were detected,21 cases were diagnosed by prenatal ultrasound diagnosis,the diagnostic accuracy was 87.50%,and the missed diagnosis rate was 12.50%.In 19 cases,only CHD was confirmed by autopsy examination after induction of labor,and 5 cases were confirmed by post-natal ultrasound examination.Of the 24 CHD fetuses,13 were congenital heart disease alone,including 4 cases of complete aortic transposition,3 cases of left ventricular dysplasia,1 case of tetralogy of Fallot,and 5 cases of complete endocardial pad defect.11 cases of external deformity,including 1 case of tricuspid valvular deformity with hydronephrosis,lung cystadenocarcinoma,7 cases of ventricular septal defect with hydronephrosis,luminal inversion,umbilical bulging,1 case of tetralogy of Fallot There were less amniotic fluid,scoliosis,1 case of persistent left superior vena cava with hydronephrosis,and 1 case of right ventricular double exit combined with clubfoot.11 fetuses with CHD and extracardiac malformation were followed up,10 of them were selected for induction of labor,1 case of ventricular septal defect with hydronephrosis,inverted cavity,umbilical bulging pregnant women chose to continue pregnancy,postpartum follow-up pregnancy outcome and prenatal The results of ultrasound diagnosis are basically the same.Conclusion:Prenatal ultrasound diagnosis is of high clinical value in congenital heart disease combined with extracardiac malformation,and it has a certain guiding effect on prenatal and postnatal care.