McAuliffe Fionnuala M, Trines Jean, Nield Lynne E, Chitayat David, Jaeggi Edgar, Hornberger Lisa K
Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Canada.
Am J Obstet Gynecol. 2005 Sep;193(3 Pt 2):1253-9. doi: 10.1016/j.ajog.2005.05.086.
This study was undertaken to evaluate the feasibility and to report the detection rate of cardiac anomalies with fetal echocardiography before 16 weeks' gestation.
This is a retrospective and prospective study of 160 early fetal echocardiograms. The mean gestational age was 13.5 weeks' gestation (range 11-15+6). All women had a repeat echocardiogram at 18 weeks' gestation and pregnancy outcome was obtained.
In all cases, a cardiac 4-chamber view was obtained. The atrioventricular valves were accurately seen in 154 (96%) cases; the ascending aorta and main pulmonary artery were visualized in 152 cases (95%). Overall, a satisfactory cardiac examination was feasible in 152 of cases (95%). There were 20 cardiac defects in this cohort (12.5%), 14 showed abnormalities at the time of the early ultrasound, whereas 6 were reported as normal. The sensitivity of early fetal echocardiography in this high-risk population was 70%, specificity 98%, positive predictive value 87.5%, and negative predictive value 96%.
The fetal heart can be examined early in pregnancy and a significant proportion of major cardiac defects identified.
本研究旨在评估妊娠16周前进行胎儿超声心动图检查心脏异常的可行性并报告其检出率。
这是一项对160例早期胎儿超声心动图的回顾性和前瞻性研究。平均孕周为13.5周（范围11 - 15⁺⁶周）。所有孕妇在妊娠18周时重复进行超声心动图检查并获得妊娠结局。
所有病例均获得心脏四腔心切面图像。154例（96%）可准确观察到房室瓣；152例（95%）可显示升主动脉和主肺动脉。总体而言，152例（95%）可行满意的心脏检查。该队列中有20例心脏缺陷（12.5%），其中14例在早期超声检查时显示异常，而6例报告为正常。早期胎儿超声心动图在该高危人群中的敏感性为70%，特异性为98%，阳性预测值为87.5%，阴性预测值为96%。
孕期早期可对胎儿心脏进行检查，并能发现相当比例的主要心脏缺陷。
