Yoshikane Yukako, Yoshizato Toshiyuki, Maeno Yasuki, Nishibatake Makoto, Kan Nobuhiko, Fusazaki Naoki, Hirose Shinichi
Department of Pediatrics, School of Medicine, Fukuoka University, Fukuoka, Japan.
J Obstet Gynaecol Res. 2011 Jul;37(7):775-81. doi: 10.1111/j.1447-0756.2010.01432.x. Epub 2011 Mar 13.
To determine the current status of fetal CHD screening in our region and to establish a CHD screening system in Japan.
Subjects were 168 fetuses prenatally-diagnosed with CHD at four referral centers in Japan from 2003 to 2007. Subjects were divided into two groups: group A (n = 84) included cases without extracardiac sonographic abnormalities and known risk factors for CHD and group B (n = 84) included those with extracardiac sonographic abnormalities or risk factors. The diagnostics and outcomes between the groups were analyzed.
There were more cases of single ventricle and restrictive ductus arteriosus and fewer cases of ventricular septal defect and double outlet right ventricle in group A than in group B (P < 0.05). In group A, the most frequent referral reason was an abnormal four-chamber view. In group B, 37 cases had chromosomal anomalies. The mortality rates in group B were higher than those in group A (P < 0.05). There were no differences in mortality rates between fetuses without chromosomal anomalies in group B and group A.
Prenatally-diagnosed CHD were mostly limited to those cases with obvious abnormalities in the four-chamber view or those with chromosomal anomalies. Prenatal detection of CHD is useful for the prediction of outcomes.
确定本地区胎儿先天性心脏病（CHD）筛查的现状，并在日本建立CHD筛查系统。
研究对象为2003年至2007年在日本四个转诊中心产前诊断为CHD的168例胎儿。研究对象分为两组：A组（n = 84）包括无心脏外超声异常及已知CHD危险因素的病例，B组（n = 84）包括有心脏外超声异常或危险因素的病例。分析两组之间的诊断情况及结局。
A组单心室和动脉导管狭窄的病例数多于B组，室间隔缺损和右心室双出口的病例数少于B组（P < 0.05）。在A组，最常见的转诊原因是四腔心切面异常。在B组，37例有染色体异常。B组的死亡率高于A组（P < 0.05）。B组和A组中无染色体异常的胎儿死亡率无差异。
产前诊断的CHD大多局限于四腔心切面有明显异常的病例或有染色体异常的病例。产前检测CHD对结局预测有用。
