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目的评价超声检测中孕早期胎儿的静脉导管血流频谱,筛查胎儿心脏畸形的意义。方法对2015年1月~2016年11月,近2年来在我院门诊超声检查的2952例孕12~16w的孕妇行胎儿静脉导管频谱检测观察a谷形态。分析静脉导管频谱a谷缺失或倒置与胎儿心脏畸形之间的关联性。结果检测2952例中孕早期胎儿的静脉导管血流频谱观察a谷形态,发现a谷缺失或倒置胎儿63例,后续跟踪至20~28w行胎儿超声心动图检查诊断心脏异常34例。静脉导管血流频谱a谷形态未见异常的胎儿,在后续的产检中发现心脏畸形有10例。静脉导管频谱a谷缺失或倒置预测胎儿先天性心脏畸形的敏感性、特异性、阳性预测值、准确性分别为77%、97%、35%、97%。结论胎儿静脉导管频谱a谷缺失或倒置与胎儿心脏畸形存在相关性[3],可作为中孕早期筛查胎儿心脏异常的辅助性方法,有其不可取代的临床意义。
Objective To evaluate the frequency of venous catheter blood flow in the first trimester of pregnancy by ultrasound and screen the significance of fetal cardiac malformation. Methods From January 2015 to November 2016, 2952 pregnant women with 12 ~ 16w pregnant women who underwent ultrasonography in our hospital in recent 2 years were examined for the morphology of a-valley by means of fetal catheterization. Analysis of the relationship between a venous catheter spectrum a-valgus loss or inversion and fetal heart deformity. Results A total of 2952 fetuses in the early stage of fetus were examined for venous blood flow spectrum. A valley morphology was observed. A total of 63 cases of fetal a missing or inverted fetus were found, followed by follow-up to 20-28 weeks. Fetal echocardiography was used to diagnose cardiac abnormalities in 34 cases. Intravenous catheter flow spectrum a valley morphology no abnormal fetus, found in the follow-up examination of heart malformation in 10 cases. The sensitivity, specificity, positive predictive value and accuracy of venous catheter spectrum a missing or inverted predicted fetal congenital heart malformation were 77%, 97%, 35% and 97%, respectively. Conclusion Fetal venous catheter a missing or inverted fetal heart malformations associated with the existence of [3], can be used as an early pregnancy screening for fetal heart abnormality auxiliary method, has its irreplaceable clinical significance.