超声心动图的四腔心切面产前诊断胎儿先天性心脏病的价值

目的 探讨超声心动图的四腔心切面（四腔心切面）产前诊断胎儿先天性心脏病（先心病）的价值。方法 回顾性分析780例妊娠16-36周通过四腔心切面进行产前诊断是的孕妇及其新生儿的临床资料。结果 780例胎儿中,94.6%,(738/780)的胎儿可以获取满意的四腔心切面,其中3例胎儿异常,1例为三尖瓣下移畸形（Ebstein综合征）,1例为严重的室间隔缺损,1例为单心房单心室和主动脉狭窄,例1和例3分别于出生后行尸体解剖和新生儿超声心动图检查,均符合产前诊断,例2出生后超声心动图检查证实为单心房和单心室,其余777例新生儿中,出生后身体检查并追踪至产后6周,发现3例先心病,其中1例室间隔缺损,1例房间隔缺损,1例房间隔缺伴肺动脉狭窄,四腔心切面诊断胎儿先心病的敏感性为50%,特异性为100%。结论 四腔心切面可以显示胎儿心脏的大部分结构,探测成功率高,对先心病的宫内诊断有较高的敏感性和极高的特性,可将胎儿四腔心切面作为常规的产检查项目。

Value of four-chamber view of the fetal echocardiography for the prenatal diagnosis of congenital heart dise

Objective To investigate the value of four chamber view for the prenatal diagnosis of congenital heart disease Methods A total of 780 fetal hearts were examined by the four chamber view between 16 and 36 weeks of gestation, and the clinical data were analyzed and the newborns were followed Results Among the 780 fetus, the four chamber view was obtained in 94 6% of the fetus and three of them were found abnormal and heart malformations were diagnosed One was Ebstein syndrome, the second was seriously ventricular septal defect and the third was single ventricle and single atrium The first and the third case were confirmed after birth by echocardiography and autopsy, and the second case was single ventricle and single atrium diagnosed by echocardiography of the newborn The other 777 newborns were followed to six weeks after birth Three more heart malformations were diagnosed One is ventricular septal defect, one is atrial septal defect and the third is pulmonary artery stenosis with atrial septal defect The sensitivity of the four chamber view for the prenatal diagnosis of the congenital heart disease is 50% and the specificity is 100% Conclusions The four chamber view of fetal heart shows the majority structures of the fetal heart and the successive rate of detection is high It has a higher sensitivity and a very high specificity for the identification of congenital heart disease We advocate the four chamber view of fetal heart as a basic obstetric scanning