Ozkutlu Süheyla, Akça Tülay, Kafali Gülden, Beksaç Sinan
Department of Pediatric Cardiology, School of Medicine, Hacettepe University, Ankara, Turkey.
Anadolu Kardiyol Derg. 2010 Jun;10(3):263-9. doi: 10.5152/akd.2010.068.
Fetal echocardiography (FE) is considered for fetal, maternal or hereditary reasons in pregnants with suspect of intrauterine heart disease (IUHD). However, in few studies it was reported that most of the fetuses with IUHD are in the low-risk group (suspicion of IUHD during 2nd trimester ultrasound, lack of good vision of the heart, self-referral). Our aim is to examine retrospectively the reasons for referral of pregnants, the results of FE, distribution of pregnants having fetuses with IUHD according to low- and high- risk factors and to evaluate reliability of FE.
Our study group consisted of 1395 fetuses and 1370 pregnants underwent FE between 1999 and 2006. These cases included self-referred women and the pregnants having previous child or family history of cardiac anomaly or referred by obstetricians. The prevalence of IUHDs in low- and high- risk pregnancies was compared by Chi-Square test.
The low risk group included 453 patients and the remaining 917 women were in the high- risk group. Intrauterine heart diseases were detected in 152 (10.9%) of 1395 fetuses. The prevalence of IUHDs was 19% in the low- risk group and 7% in the high-risk group. Of the 152 fetuses 56.6% were in the low-risk group and 43.4% were in the high- risk group. The sensitivity of FE for diagnose of IUHDs was 97%, the specificity was 100%.
Fetal echocardiography is highly reliable method for diagnosing of IUHDs. The most IUHDs occur in the low- risk group.
对于怀疑患有宫内心脏病（IUHD）的孕妇，出于胎儿、母亲或遗传因素考虑会进行胎儿超声心动图检查（FE）。然而，少数研究报告称，大多数患有IUHD的胎儿属于低风险组（孕中期超声检查怀疑患有IUHD、心脏视野不佳、自行转诊）。我们的目的是回顾性研究孕妇转诊的原因、FE的结果、根据低风险和高风险因素划分的患有IUHD胎儿的孕妇分布情况，并评估FE的可靠性。
我们的研究组由1999年至2006年间接受FE检查的1395例胎儿和1370例孕妇组成。这些病例包括自行转诊的女性、有心脏病患儿或家族病史的孕妇或由产科医生转诊的孕妇。通过卡方检验比较低风险和高风险妊娠中IUHD的患病率。
低风险组包括453例患者，其余917名女性属于高风险组。1395例胎儿中有152例（10.9%）检测出宫内心脏病。低风险组中IUHD的患病率为19%，高风险组为7%。在这152例胎儿中，56.6%属于低风险组，43.4%属于高风险组。FE诊断IUHD的敏感性为97%，特异性为100%。
胎儿超声心动图是诊断IUHD的高度可靠方法。大多数IUHD发生在低风险组。
