Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK.
Fetal Diagn Ther. 2011;29(2):127-34. doi: 10.1159/000322138. Epub 2010 Dec 16.
To determine whether assessment of ductus venosus flow at 11-13 weeks' gestation improves the detection rate of cardiac defects achieved by screening with nuchal translucency (NT) thickness.
Prospective first-trimester screening for aneuploidies, including measurement of fetal NT and assessment of ductus venosus flow. The performance of different combinations of increased fetal NT and abnormal blood flow in the ductus venosus in screening for major cardiac defects was examined.
The study population of euploid fetuses included 85 cases with major cardiac defects and 40,905 with no cardiac defects. The fetal NT was above the 95th and above the 99th centile in 30 (35.3%) and 18 (21.2%) of the fetuses with cardiac defects, respectively, and in 1,956 (4.8%) and 290 (0.7%) of those without cardiac defects, respectively. Reversed a-wave was observed in 24 (28.2%) of the fetuses with cardiac defects and in 856 (2.1%) of those with no cardiac defects. Specialist fetal echocardiography for cases with NT above the 99th centile and those with reversed a-wave, irrespective of NT, would detect 38.8% of major cardiac defects at an overall false- positive rate of 2.7%.
Assessment of ductus venosus flow improves the performance of NT screening for cardiac defects.
确定在 11-13 孕周评估静脉导管血流是否能提高颈项透明层（NT）厚度筛查检测出心脏缺陷的检出率。
对包括胎儿 NT 测量和静脉导管血流评估在内的胎儿进行前瞻性的早孕期筛查。检查不同的 NT 增厚和静脉导管血流异常组合在筛查主要心脏缺陷方面的表现。
在包括 85 例有主要心脏缺陷的胎儿和 40905 例无心脏缺陷的胎儿在内的研究人群中，分别有 30 例（35.3%）和 18 例（21.2%）胎儿的 NT 值超过第 95 百分位数，分别有 1956 例（4.8%）和 290 例（0.7%）胎儿的 NT 值超过第 99 百分位数。在有心脏缺陷的胎儿中，24 例（28.2%）观察到反向 a 波，而在无心脏缺陷的胎儿中，856 例（2.1%）观察到反向 a 波。对 NT 值超过第 99 百分位数和出现反向 a 波的病例进行专家胎儿超声心动图检查，无论 NT 值如何，将以 2.7%的总体假阳性率检测出 38.8%的主要心脏缺陷。
评估静脉导管血流可提高 NT 筛查心脏缺陷的性能。
