Yagel Simcha, Cohen Sarah M, Messing Baruch
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centers, Jerusalem, Israel.
Curr Opin Obstet Gynecol. 2007 Apr;19(2):183-90. doi: 10.1097/GCO.0b013e3280895de6.
This review describes the recent advances in timing and effectiveness of first and early second trimester fetal echocardiography screening.
Fetal echocardiography can now be reliably performed from 11 weeks' gestation owing to improvements in ultrasound transducers and processors. Three-dimensional and four-dimensional ultrasound modalities in image acquisition and postprocessing analysis, including spatio-temporal image correlation, rendering three-dimensional power Doppler and high definition power flow Doppler, and B-flow have further improved our capabilities in this area. Fetal nuchal translucency measurement screening programs create a new population of at-risk pregnancies that will be referred for early fetal echocardiography. The majority of congenital heart defects, however, still occur in low-risk patients. Improved technology has lowered the gestational age at which fetal cardiac anatomy scanning can be reliably performed by properly trained and experienced examiners.
Early fetal echocardiography can be offered as a screening examination to at-risk and low-risk patients, with the proviso that it be repeated following screen-negative scans at mid-gestation to exclude later developing lesions.
本综述描述了孕早期和孕中期早期胎儿超声心动图筛查在时间安排和有效性方面的最新进展。
由于超声换能器和处理器的改进，现在从妊娠11周起就可以可靠地进行胎儿超声心动图检查。图像采集和后处理分析中的三维和四维超声模式，包括时空图像相关技术、三维能量多普勒成像、高清能量血流多普勒成像以及B-flow成像，进一步提高了我们在这一领域的能力。胎儿颈部透明带测量筛查项目产生了一批新的高危妊娠人群，这些孕妇将被转诊进行早期胎儿超声心动图检查。然而，大多数先天性心脏缺陷仍发生在低风险患者中。技术的改进降低了经过适当培训和有经验的检查人员能够可靠地进行胎儿心脏解剖结构扫描的孕周。
早期胎儿超声心动图可作为对高危和低风险患者的筛查检查，但前提是在孕中期筛查结果为阴性后需再次检查，以排除后期出现的病变。
