孕中晚期胎儿超声心动图转诊因素分析

发布时间：2018-11-18 06:18

【摘要】：目的分析胎儿超声心动图转诊指征与产前检出胎儿心脏异常之间的关系。方法回顾性分析1 032例转诊行胎儿超声心动图检查的孕妇。所有转诊病例分为单指征组和多指征组,分析转诊指征的分布情况,统计产前胎儿心脏异常的检出率,并评估转诊指征与产前心脏畸形检出之间的关系。结果在单指征组中,885例转诊病例共检出172例(19.4%)胎儿心脏异常,通过logistic回归分析发现,孕中期胎儿畸形筛查发现可疑心脏切面与产前诊断胎儿心脏异常相关(OR=13.7,95%CI为9.40~20.00),孤立性心内强回声灶与产前胎儿心脏异常的检出率呈负相关(OR=0.24,95%CI为0.11~0.56)。在多指征组中,产前胎儿心脏异常检出率增加至27.2%(P=0.336),其中具有胎儿指征的病例,产前诊断胎儿心脏异常的风险明显升高。结论孕中期胎儿畸形筛查超声检查中发现可疑心脏结构畸形作为单个转诊指征与产前胎儿心脏异常的检出相关,而心腔内的孤立性心内强回声灶不应继续作为进一步转诊胎儿超声心动图的指征。对于具有多个转诊胎儿超声心动图指征的孕妇,如果多个指征中有1个是胎儿指征,胎儿心脏异常的产前检出率显著升高。
[Abstract]:Objective to analyze the relationship between fetal echocardiographic referral and prenatal detection of fetal cardiac abnormalities. Methods 1 032 pregnant women who were referred to fetal echocardiography were analyzed retrospectively. All referrals were divided into single indication group and multiple indication group. The distribution of referral indications was analyzed, the detection rate of fetal cardiac abnormalities was counted, and the relationship between the referral indications and the detection of prenatal cardiac malformations was evaluated. Results in the single indication group, 172 (19.4%) fetal heart abnormalities were detected in 885 cases of referrals, which were found by logistic regression analysis. Screening of fetal malformation in the second trimester of pregnancy showed that suspicious cardiac section was correlated with abnormal fetal heart in prenatal diagnosis (OR=13.7,95%CI was 9.40 ~ 20.00). There was a negative correlation between isolated intracardiac hyperechoic foci and prenatal fetal heart abnormalities (OR=0.24,95%CI = 0.110.56). In the multiple indication group, the detection rate of fetal heart abnormality increased to 27.2% (P0. 336). The risk of prenatal diagnosis of fetal cardiac abnormality was significantly increased in the cases with fetal indication. Conclusion during the second trimester fetal malformation screening, suspicious cardiac structural malformation was found to be related to the detection of fetal heart abnormalities before delivery as a single referral sign. Isolated intracardiac hyperechoic foci should not continue to be used as indicators for further referral of fetal echocardiography. For pregnant women with multiple fetal echocardiographic indications, if one of the multiple indications is a fetal indication, the prenatal detection rate of fetal heart abnormalities is significantly increased.
【作者单位】：上海交通大学医学院附属新华医院小儿心血管科;
【基金】：2014年上海卫生系统重要疾病联合攻关项目(2013ZYJB0016) 2014年上海交通大学医学院科技基金项目(14XJ10045)~~
【分类号】：R540.45;R714.5

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