Itsukaichi Mina, Serikawa Takehiro, Yoshihara Kosuke, Suzuki Hiroshi, Haino Kazufumi, Yamaguchi Masayuki, Enomoto Takayuki, Takakuwa Koichi
Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Department of Pediatrics, Niigata University School of Medicine, Niigata, Japan.
J Obstet Gynaecol Res. 2018 Jan;44(1):49-53. doi: 10.1111/jog.13472. Epub 2017 Nov 2.
We aimed to assess the accuracy and effectiveness of fetal cardiac screening for congenital heart disease (CHD) during the second trimester by general obstetricians in a non-selected population.
In this multicenter, prospective cohort study of fetal cardiac screening, four-chamber and three-vessel views were recorded by obstetricians at 18-21 gestational weeks (GW). A total of 3005 fetuses that were scheduled for delivery at our institution were included.
Thirty-seven newborns were born with CHD (1.2%). On excluding 23 cases of ventricular septal defects, the prenatal detection rate of CHD was 42.8%. Although six cases (75.0%) of severe structural abnormality were diagnosed prenatally, the prenatal detection rate of valvular abnormalities was 0%.
One-point ultrasound screening of the fetal heart using a combination of four-chamber and three-vessel views at 18-21 GW by general obstetricians in a non-selected population may be useful for detecting severe structural abnormalities but not valvular abnormalities. However, this limitation may be improved by conducting another fetal cardiac screening at approximately 30 GW along with the routine use of color Doppler.
我们旨在评估普通产科医生在未选择人群中于孕中期进行胎儿先天性心脏病（CHD）心脏筛查的准确性和有效性。
在这项胎儿心脏筛查的多中心前瞻性队列研究中，产科医生在妊娠18 - 21周（GW）时记录四腔心和三血管切面图像。共纳入了3005例计划在我们机构分娩的胎儿。
37例新生儿患有先天性心脏病（1.2%）。排除23例室间隔缺损病例后，先天性心脏病的产前检出率为42.8%。虽然6例（75.0%）严重结构异常在产前被诊断出来，但瓣膜异常的产前检出率为0%。
普通产科医生在未选择人群中于妊娠18 - 21周使用四腔心和三血管切面联合进行胎儿心脏单点超声筛查，可能有助于检测严重结构异常，但对瓣膜异常无效。然而，通过在大约妊娠30周时进行另一次胎儿心脏筛查并常规使用彩色多普勒，这一局限性可能会得到改善。
