|
|
|
| The application of echocardiography in diagnosing fetal severe congenital heart disease at first trimester |
| ZHANG Jun, Deng Xu-dong, PAN Qi, YIN Lin-liang, MA Jian-fang, YANG Zhong, GOU Zhong-shan |
| Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Jiangsu 215000, China |
|
|
|
|
Abstract Objective: To investigate the application value of first trimester fetal echocardiography in the prenatal diagnosis of severe congenital heart disease(CHD). Methods: First trimester fetal echocardiography was performed in 1 209 fetuses. Four-chamber view, three vessels and trachea view, left ventricular outflow tract view, right ventricular outflow tract view and aortic arch view were obtained. Patients with suspected cardiac abnormalities were reexamined for fetal echocardiography after 2-4 weeks. Pathological examination is required for induced labor after diagnosis. Fetal echocardiography was performed at 18-24 weeks for those who continue pregnancy. All live births were followed up by echocardiography. Results: Thirteen fetuses with severe congenital heart disease were diagnosed by first trimester fetal echocardiography, including 7 cases of conotruncal anomalies, 3 cases of hypoplastic left heart syndrome, 2 cases of atrioventricular septal defect and 1 case of Ebstein’s anomaly. 16 cases were confirmed in mid-pregnancy and post-natal follow-up, one case was missed and 4 cases were misdiagnosed. The diagnostic accordance rate was 68.7%(11/16). Conclusions: Most CHDs could be diagnosed by first trimester fetal echocardiography, especially those with abnormal four chambers views. Echocardiography in early pregnancy has important application value in the diagnosis of severe congenital heart disease.
|
|
Received: 09 October 2018
|
|
|
|
|
|
[1]中华医学会儿科学分会心血管学组，中国医师协会儿科医师分会先天性心脏病专家委员会，《中华儿科杂志》编辑委员会. 胎儿先天性心脏病诊断及围产期管理专家共识[J]. 中华儿科杂志，2015，53（10）：728-733.
[2]李胜利，罗国阳. 胎儿畸形产前超声诊断学[M]. 第2版. 北京：科学出版社，2017：305-306.
[3]张炼. 先天性心脏病遗传学基础研究进展[J]. 中华实用儿科临床杂志，2016，31（13）：969-972.
[4]Nicolaides KH. A model for a new pyramid of prenatal care based on the 11 to 13 weeks’ assessment[J]. Prenat Diagn, 2011, 31(1): 3-6.
[5]黄巧燕，张棣，黄毅锋，等. 二维超声“三切面”法筛查胎儿先天性心脏畸形[J]. 中国医学影像技术，2009，25（9）：1654-1656.
[6]Volpe Pl, Ubaldo P, Volpe N, et al. Fetal cardiac evaluation at 11~14 weeks by experienced obstetricians in a low-risk population[J]. 2011, 31(11): 1054-1061.
[7]耿丹明，吴琳琅，陈桑，等. 经腹部超声心动图在孕早期胎儿先天性心脏病诊断中的应用价值[J]. 中华医学超声杂志：电子版，2016，13（1）：45-50.
[8]任卫东，胡金玲. 圆锥动脉干相关心血管畸形的再认识：从解剖学到胚胎学、基因学[J/CD]. 中华医学超声杂志：电子版，2017，14（3）：161-166.
[9]董凤群，张晓花，贺新建，等. 超声检查肺门部大血管横切面预测胎儿心脏锥干系统疾病的价值[J]. 临床超声医学杂志，2014，16（4）：271-273.
[10]王红鹄，杨军，韩舒，等. 三血管及三血管气管切面在超声产前诊断胎儿心脏大血管畸形中的应用价值[J]. 中国临床医学影像杂志，2015，26（3）：192-196.
[11]Jones RS, Junor L, Hutson MR, et al. Conotruncal Heart Defects: Altered Tissue Morphology and Hemodynamics[J]. Microsc Microanalysis, 2017, 23(1): 1174-1175.
[12]任卫东，张玉奇，舒先红，等. 心血管畸形胚胎学基础与超声诊断[M]. 北京：人民卫生出版社，2015：112-114.
[13]刘晓伟，何怡华，张烨. 胎儿心脏超声检查常见误诊与漏诊分析[J]. 中国医学影像技术，2015，31（4）：593-596. |
|
|
|
2019, Vol. 30 
