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[胎儿超声心动图对先天性心脏病产前诊断的准确性:中国一家三级产科中心的7年经验]

[Accuracy of prenatal diagnosis of congenital heart defects by fetal echocardiography: a 7-year experience in a Chinese tertiary obstetric center].

作者信息

Zhu Ruo-yan, Li Li-chan, Chen Rui-yu, Shi Li-ye, Niu Jian-mei, Wang Xiao, Wang Jin-jin

机构信息

Department of Ultrasound, International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University, Shanghai 200030, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Apr;37(4):343-6.

Abstract

OBJECTIVE

To evaluate the prenatal diagnostic accuracy of fetal echocardiography for congenital heart defects.

METHODS

Fetal echocardiographic databases from 2001 to 2007 were searched for patients with a prenatal diagnosis of congenital heart defect, medical records were obtained and the prenatal echocardiographic findings were correlated with postnatal echocardiography results or autopsy findings, if the pregnancy was terminated or the fetus died in utero.

RESULTS

Prenatal diagnosis of congenital heart defects was made in 113 pregnancies at a mean gestational age of 26.8 weeks. Pathology or postnatal echocardiography was available in 79 cases (70%) and the accuracy of prenatal diagnosis was 86% (68/79). Prenatal diagnosis was accurate in 24 of 31 patients (77%) with conotruncal malformations, 26 of 27 patients (96%) with septal defects, 9 of 10 patients (90%) with valve abnormalities, and 5 of 6 patients (83%) with univentricular hearts. There were 4 false-positives and the positive predictive value was 95% (75/79).

CONCLUSION

Fetal echocardiography is a reliable tool for prenatal diagnosis of congenital heart defects despite limitations for correctly diagnosing some specific fetal heart defects.

摘要

目的

评估胎儿超声心动图对先天性心脏缺陷的产前诊断准确性。

方法

检索2001年至2007年胎儿超声心动图数据库中产前诊断为先天性心脏缺陷的患者,获取病历资料,若妊娠终止或胎儿死于宫内,则将产前超声心动图检查结果与产后超声心动图结果或尸检结果进行对比。

结果

113例妊娠中产前诊断出先天性心脏缺陷,平均孕周为26.8周。79例(70%)有病理学检查结果或产后超声心动图结果,产前诊断的准确率为86%(68/79)。31例圆锥干畸形患者中有24例(77%)产前诊断准确,27例房间隔缺损患者中有26例(96%)诊断准确,10例瓣膜异常患者中有9例(90%)诊断准确,6例单心室患者中有5例(83%)诊断准确。有4例假阳性,阳性预测值为95%(75/79)。

结论

尽管在正确诊断某些特定胎儿心脏缺陷方面存在局限性,但胎儿超声心动图仍是先天性心脏缺陷产前诊断的可靠工具。

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