Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, Netherlands.
Medical library, Vrije Universiteit, Amsterdam, Netherlands.
Int J Gynaecol Obstet. 2018 Feb;140(2):137-145. doi: 10.1002/ijgo.12373. Epub 2017 Nov 22.
The prenatal detection rate of congenital heart defects (CHDs) is increasing, but reported rates vary.
To determine the performance of the second-trimester anomaly scan to detect CHD.
PubMed and Embase were searched for relevant studies in any language from inception to February 3, 2017. The search terms included "prenatal diagnosis" or "pregnancy," "cardiovascular diseases" or "cardiac defects," "congenital," and "specificity," or "sensitivity," or "cohort study."
Cohort studies assessing the detection rate of CHD during population-based prenatal screening from 1995 were eligible for inclusion.
Data were collected from identified studies; authors were approached for additional data when necessary. A review and meta-analysis were performed. When possible, separate analyses were undertaken for isolated CHD cases.
Meta-analysis of seven studies showed the pooled detection rate of CHD in unselected populations as 45.1% (95% confidence interval 33.5%-57.0%). However, the rate of detection of univentricular defects and heterotaxy was above 85%. Similar rates were found among cases of isolated CHD.
Prenatal detection showed a strong correlation with CHD severity. The detection of conotruncal anomalies needs to improve. A thoroughly organized screening program will be essential to achieve a higher detection rate.
先天性心脏病（CHD）的产前检出率不断提高，但报道的检出率存在差异。
评估中孕期畸形筛查检测 CHD 的性能。
检索了 1995 年以来以任何语言发表的关于基于人群的产前筛查中 CHD 检出率的队列研究，检索词包括“产前诊断”或“妊娠”、“心血管疾病”或“心脏缺陷”、“先天性”以及“特异性”或“敏感性”或“队列研究”。
评估 1995 年以来基于人群的产前筛查中 CHD 检出率的队列研究。
从确定的研究中提取数据；必要时联系作者获取额外数据。进行综述和荟萃分析。如果可能，对孤立性 CHD 病例进行单独分析。
荟萃分析 7 项研究显示，未选择人群中 CHD 的总检出率为 45.1%（95%置信区间 33.5%-57.0%）。然而，单心室缺陷和内脏异位的检出率高于 85%。孤立性 CHD 病例中也发现了相似的检出率。
产前检出与 CHD 严重程度密切相关。需要提高圆锥动脉干畸形的检出率。为了实现更高的检出率，需要制定全面的筛查方案。
