Johnson P, Sharland G, Maxwell D, Allan L
Fetal Medicine Unit, Guy's Hospital, London, UK.
Ultrasound Obstet Gynecol. 1992 Jul 1;2(4):248-51. doi: 10.1046/j.1469-0705.1992.02040248.x.
The antenatal diagnosis of congenital heart disease by fetal echocardiography is rarely achieved before 18-20 weeks' gestation. Transvaginal sonography allows examination of fetal anatomy at earlier gestations than the transabdominal approach. In a screening study of 270 low-risk women between 8 and 14 weeks' gestation using a 5 MHz vaginal transducer, it was possible to obtain adequate four-chamber views in over 70% from 12 weeks. In a second study of 32 women at high risk of congenital heart disease scanned between 14 and 15 weeks' gestation, satisfactory views were obtained transvaginally in 21 women. Seven of the remainder had normal cardiac anatomy confirmed by transabdominal scanning. In three of the four where normal cardiac anatomy could not be demonstrated by either transvaginal or transabdominal scanning, severe congenital heart disease was diagnosed and later confirmed. It is unlikely that transvaginal sonography will replace abdominal scanning for the screening of low-risk pregnancies, but it is a valuable addition to the early examination of those women identified as being at high risk of congenital heart disease.
胎儿超声心动图对先天性心脏病的产前诊断很少能在妊娠18 - 20周前实现。经阴道超声检查比经腹超声检查能在更早的孕周检查胎儿解剖结构。在一项使用5兆赫阴道探头对270名妊娠8至14周的低风险女性进行的筛查研究中，从12周起，超过70%的孕妇能够获得足够的四腔心视图。在第二项研究中，对32名先天性心脏病高风险女性在妊娠14至15周进行扫描，经阴道获得满意视图的有21名女性。其余女性中有7名经腹扫描证实心脏解剖结构正常。在4名经阴道或经腹扫描均无法显示正常心脏解剖结构的女性中，有3名被诊断为严重先天性心脏病，随后得到证实。经阴道超声检查不太可能取代经腹超声检查用于低风险妊娠的筛查，但对于那些被确定为先天性心脏病高风险的女性，它是早期检查的一项有价值的补充。
