Study on ultrasonographic diagnosis of complex fetal congenital heart disease in the first trimester
10.3760/cma.j.cn131148-20230804-00054
- VernacularTitle:早孕期胎儿复杂先天性心脏病的超声诊断
- Author:
Shuihua YANG
1
;
Mengfeng LIANG
;
Guican QIN
;
Yan LIANG
;
Suli LUO
;
Zuojian YANG
;
Yulan PANG
;
Feiwen LONG
;
Yanni TANG
;
Guidan HE
Author Information
1. 广西壮族自治区妇幼保健院超声医学科，南宁 530000
- Keywords:
Ultrasonography, prenatal;
First trimester;
Congenital heart disease
- From:
Chinese Journal of Ultrasonography
2024;33(1):27-35
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the diagnostic accuracy and prognosis of fetal congenital heart disease (CHD) detected by ultrasound at 11-13 weeks gestation.Methods:Fetuses at 11 to 13 + 6 weeks gestation in the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region between January 2015 and December 2022 were prospectively collected. Standrardized ultrasound was used to examine the fetuses. For the suspected fetal CHD, the section of cardiac ultrasound was improved as far as possible, and ultrasonic results, prenatal diagnosis, pathological anatomy and pregnancy outcome were followed up. Results:A total of 539 cases of CHD were detected in 72 242 fetuses with mixed risk in the first trimester, the incidence was 0.75% (539/72 242). The incidence of CHD in the fetuses with positive soft markers was 9.20% (287/3 118), and the incidence of multiple fetal malformations was 16.22% (235/1 449). The diagnostic accordance rate of complex CHD was 97.42%. For complex CHD, the sensitivity, specificity, false positive rate and false negative rate of first-trimester ultrasound were 90.41%, 99.98%, 0.02%, 9.59%. Combined with the results of this study, the abnormal section model of complex CHD was recommended. A total of 252 cases underwent staining chromosomal microarray or gene sequencing, of which 42.46% (107/252) were positive.Conclusions:Standardized ultrasound examination has a very high detection rate for fetal CHD in the first trimester. Transverse scanning of the heart can significantly improve the display of gray scale cardiac section, and reference to the cardiac section pattern map is beneficial to the early diagnosis of fetal CHD.
