孕11～13+6周超声筛查胎儿心脏严重畸形的临床价值  

Clinical value of ultrasonography in screening fetal severe cardiac malformations at 11-13+6 weeks gestation

作　　者：黄淑娴[1] 佘玲娜[1] 曾梅[1] 刘利娜[1] HUANG Shu-xian;SHE Ling-na;ZENG Mei;LIU Li-na(Department of Ultrasound, Meizhou People's Hospital, Guangdong Province, Meizhou 514000, China)

机构地区：[1]广东省梅州市人民医院超声科

出　　处：《中国当代医药》2019年第16期183-185,共3页China Modern Medicine

摘　　要：目的探讨孕11~13^+6周产前超声筛查胎儿心脏严重畸形的临床价值。方法选取2016年1月~2018年12月我院产前诊断中心5128例孕妇作为研究对象,将其孕11~13^+6周行颈项透明层(NT)超声规范化结构筛查,所有孕妇均采取四腔心切面(4CV)及三血管气管切面(3VVT)对胎儿心脏进行筛查,并对两种方法单独应用和联合应用对筛查出的心脏严重畸形结果进行回顾性分析。结果孕11~13^+6周来我院行NT检查的5128例孕妇,4CV、3VVT、4CV+3VVT三种方法图像获取率分别为91.56%、78.91%、95.82%。共检查出26例严重的胎儿心脏畸形,发病率0.5‰,其中4CV、3VVT、4CV+3VVT三种方法分别检查出14、7、22例心脏结构异常胎儿。三种方法诊断严重的胎儿心脏畸形的特异度相近,差异无统计学意义(P>0.05),4CV+3VVT方法诊断严重的胎儿心脏畸形的灵敏度要高于其他两种,漏诊率则低于其他两种方法(P<0.05)。结论孕妇在孕11~13+6周进行产前超声检查对胎儿心脏严重畸形筛查具有重要的临床价值,特别是4CV、3VVT联合筛查能更有效提高早孕期胎儿严重心脏畸形的诊断率。Objective To investigate the clinical value of prenatal ultrasound screening for fetal severe cardiac malformations at 11-13^+6 weeks of gestation. Methods From January 2016 to December 2018, 5128 pregnant women in the prenatal diagnosis center of our hospital were selected as the study subjects. The pregnant women were screened by NT ultrasound standardized structure at 11-13^+6 weeks of gestation. All patients were screened for fetal heart with four-chamber(4 CV) and three-vessel tracheotomy(3 VVT). The results of severe cardiac malformations detected by the two methods alone and in combination were analyzed retrospectively. Results Among the 5128 pregnant women who underwent NT examination in our hospital since 11-13^+6 weeks of gestation, the rates of obtaining 4 CV, 3 VVT, 4 CV+3 VVT by three methods were 91.56%, 78.91% and 95.82%, respectively. A total of 26 cases of severe fetal heart malformations were examined, with the incidence of 0.5‰. Among them, 14, 7 and 22 cases of abnormal cardiac structure were detected by 4 CV, 3 VVT and 4 CV+3 VVT respectively. The specificity of the three methods in the diagnosis of severe fetal heart malformation was similar, and there was no statistical difference(P>0.05). The sensitivity of 4 CV+3 VVT in the diagnosis of severe fetal heart malformation was higher than that of the other two methods, but the rate of missed diagnosis was lower than that of the other two methods(P<0 05). Conclusion Prenatal ultrasound examination in pregnant women at 11 to 13+6 weeks of gestation is of great clinical value in screening for severe fetal heart deformities, especially, the combined screening of 4 CV and 3 VVT can effectively improve the diagnosis rate of severe cardiac malformations of fetus during the first trimester of pregnancy.

关 键 词：胎儿心脏 超声 严重畸形 孕11~13^+6周 

分 类 号：R714.5[医药卫生—妇产科学]