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目的探讨超声腹腔横切面筛查胎儿先天性心血管畸形(CCVD)的价值。方法 2013年1月至2014年12月进行产检并住院分娩或进行引产的孕妇中,共对268名孕妇胎儿进行超声腹腔横切面检查。根据腹腔横切面异常胎儿腹腔横切面的下腔静脉、主动脉和奇静脉内径、数目及位置异常将CCVD分为4类:奇静脉扩张型、数目增多型、位置异常型和混合型,分析不同类型畸形的特征。结果 268例中,三维超声腹腔横切面检查结果为无CCVD的胎儿234例,发现异常者34例。34例中(9例为位置异常型,3例数目增多型,17例奇静脉扩张型,5例混合型)均在产后1~4个月进行超声心动图复查或对中止妊娠的胎儿进行尸体解剖,证实均与腹腔横切面筛查结果一致。未见异常的234中,22例产后超声心动图确诊CCVD,超声产前腹腔横切面诊断CCVD的敏感性为60.7%,诊断准确率为91.8%。结论超声腹腔横切面获取信息方法简单,不同类型畸形有不同特征,能够为CCVD的筛查提供有价值的信息。为了更好地降低CCVD的危害,提高筛检的敏感度,产前检查应结合不同切面进行超声检查。
Objective To investigate the value of transperitoneal ultrasound in the screening of fetal congenital cardiovascular malformations (CCVD). Methods From January 2013 to December 2014, a total of 268 pregnant women fetus were examined by ultrasound abdominal cross-sectional examination among pregnant women who were inspected and delivered during hospitalization or induced labor. CCVD was classified into four categories according to the IVF, aortic and azygous internal diameters, abnormalities and abnormalities in the transverse section of the abdominal cavity of the abdominal cross-section. CCVDs were classified into four categories: azygos dilation type, increased number type, abnormal position type and mixed type, Type of deformity characteristics. Results 268 cases, the three-dimensional ultrasound abdominal cross-sectional examination results for non-CCVD fetal 234 cases found abnormalities in 34 cases. Echocardiography was performed in 34 cases (9 cases with abnormal location type, 3 cases with increased number, 17 cases with ametropia dilation type and 5 cases with mixed type) after 1 to 4 months postpartum or the fetus Anatomical, confirmed with the abdominal cross-sectional screening results. In 234 cases without abnormalities, CCVD was confirmed in 22 cases of postnatal echocardiography. The sensitivity of prenatal diagnosis of CCVD was 60.7% and the diagnostic accuracy was 91.8%. Conclusion Ultrasound abdominal cross-sectional information acquisition method is simple, different types of deformities have different characteristics, can provide valuable information for CCVD screening. In order to reduce the harm of CCVD and improve the sensitivity of screening, prenatal examination should be combined with different aspects of ultrasound examination.