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妊娠早中期胎儿心血管畸形的产前超声诊断临床分析:一篇符合 CARE 标准的文章。

Clinical analysis of prenatal ultrasound diagnosis of fetal cardiovascular malformations in the first and second trimesters of pregnancy: A CARE-compliant article.

作者信息

Han Bing, Li Ying, Tang Yi, Qu Xueling, Wang Fen, Song Haibo, Xu Yinhui

机构信息

Department of Ultrasound.

Department of Cardiac Ultrasound, Weihai Municipal Hospital.

出版信息

Medicine (Baltimore). 2019 Aug;98(33):e16822. doi: 10.1097/MD.0000000000016822.

Abstract

Fetal cardiovascular malformations is widely focused and screened, but the accuracy of screening is not satisfactory. In this study, we compared the types of congenital heart malformation, accompanying diseases and fetal outcomes in the first and second trimesters of pregnancy to clarify the advantage of early screening.From January 2013 to June 2018, 230 fetuses were diagnosed with congenital heart malformations using ultrasound method in Qilu Hospital of Shandong University, and divided into 2 groups:the first trimester fetuses (group A) and the second trimester fetuses (group B). In addition, we collected and organized medical data of 347 cases diagnosed with congenital heart disease during 1998 to 2005 (group C). We compared the spectrum of congenital heart disease, associated comorbidities and outcome of fetuses diagnosed with congenital heart disease.There were differences in the types and incidence of cardiac malformations between the first and second trimesters of pregnancy. The number of cases of non-cardiac malformation, congenital heart disease with single ventricular circulation, fetal intrauterine death and premature pregnancy termination was significantly lower in the late stage (group A and group B) than that in the early stage (group C). More patients were screened for trisomy 21, 18, 13 syndromes and Turner syndrome in group A than group B (P <.001). More fetuses with a 22q11 deletion were screened in group B than group C.Early pregnancy screening using ultrasound diagnosis is very important for fetuses with congenital heart disease.

摘要

胎儿心血管畸形受到广泛关注并进行筛查,但筛查准确性并不令人满意。在本研究中,我们比较了妊娠早、中期先天性心脏畸形的类型、伴随疾病及胎儿结局,以明确早期筛查的优势。

2013年1月至2018年6月,山东大学齐鲁医院采用超声方法诊断出230例先天性心脏畸形胎儿,并分为两组:妊娠早期胎儿(A组)和妊娠中期胎儿(B组)。此外,我们收集并整理了1998年至2005年期间诊断为先天性心脏病的347例病例的医疗数据(C组)。我们比较了先天性心脏病胎儿的心脏病谱、相关合并症及结局。

妊娠早、中期心脏畸形的类型和发生率存在差异。晚期(A组和B组)非心脏畸形、单心室循环先天性心脏病、胎儿宫内死亡及早产终止妊娠的病例数显著低于早期(C组)。A组筛查21、18、13三体综合征及特纳综合征的患者多于B组(P<.001)。B组筛查出22q11缺失的胎儿多于C组。

超声诊断早期妊娠筛查对先天性心脏病胎儿非常重要。

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