Hsieh C C, Kuo D M, Chiu T H, Hsieh T T
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Gynecol Obstet Invest. 1996;42(2):84-7. doi: 10.1159/000291897.
This prospective study was designed to determine whether there would be a higher incidence of congenital cardiovascular malformation (CCVM) in pregnant women with certain risk factors. Fetal echocardiography, from second trimester of term, was performed in 1,659 pregnant women with risk factors for CCVMs and 826 pregnant women without risk factors from March 1990 to April 1995. Two-dimensional imaging, fetal M mode measurements, Doppler waveform velocity and Doppler color flow mapping were used for fetal heart examination. During this period, 70 fetuses with major cardiovascular malformations were found. The prenatal detection rate was determined as 2.8% (70/2,485) in our study. The rate in the high-risk group, however, was 3.7% (61/1,659). Of all indications, fetal risk factors had the highest rate (9.3%, 46/494) of detected CCVMs. Maternal and familial indications could be excluded from the high-risk group as they did not show any increased incidence over the low-risk group. We suggest that fetal echocardiography is mandatory in the high-risk group, especially in cases with fetal and placental risk factors. Fetal cardiac screening in the hands of first-line sonographers has a major role in prenatal diagnosis of CCVMs in the low-risk group.
这项前瞻性研究旨在确定具有某些风险因素的孕妇中先天性心血管畸形（CCVM）的发病率是否更高。1990年3月至1995年4月，对1659例有CCVM风险因素的孕妇和826例无风险因素的孕妇进行了孕中期胎儿超声心动图检查。二维成像、胎儿M型测量、多普勒波形速度和多普勒彩色血流图用于胎儿心脏检查。在此期间，发现70例患有主要心血管畸形的胎儿。在我们的研究中，产前检测率确定为2.8%（70/2485）。然而，高危组的发生率为3.7%（61/1659）。在所有指征中，胎儿风险因素检测到CCVM的发生率最高（9.3%，46/494）。由于孕产妇和家族指征在低危组中未显示任何发病率增加，因此可将其从高危组中排除。我们建议，高危组必须进行胎儿超声心动图检查，尤其是有胎儿和胎盘风险因素的病例。一线超声检查人员进行的胎儿心脏筛查在低危组CCVM的产前诊断中起主要作用。
