Clinical screening value of four-dimensional color ultrasound for the fetal congenital heart disease during the second trimes-ter of pregnancy
Objective:To explore the clinical screening value of four-dimensional color ultrasound for fetal congenital heart disease(CHD)during the second trimester of pregnancy.Methods:The clinical data of 1500 pregnant women who had undergone prenatal CHD screening by four-dimensional color Doppler ultrasound in the hospital from March 2020 to September 2023 were selected as the research subjects retrospectively.The diagnosis of fetal CHD was based on the examination result of the neonatal echocardiography after delivery and the presence of CHD symptoms of the ne-onates during 6 months of follow-up,and the screening efficacy of four-dimensional color Doppler ultrasound for the fetal CHD was analyzed.Results:Among 1500 fetuses,20(1.3％)fetuses were diagnosed with CHD.Four-dimen-sional color Doppler ultrasound detected 17 fetuses with the true positive CHD,1474 fetuses with the true negative CDH,6 fetuses with the false positive CDH and 3 fetuses with the false negative CHD.The sensitivity,the specificity,the accuracy,the positive predictive value and the negative predictive value of the four-dimensional color Doppler ultra-sound of the pregnant women for their fetal CHD were 85.0％,99.6％,99.4％,73.9％and 99.8％,respectively.A-mong 20 fetuses with CHD,there were 6 cases with ventricular septal defect,5 cases with double outlet right ventri-cle,4 cases with tricuspid regurgitation,3 cases with transposition of the great arteries and 2 cases with coarctation of the aorta.Four-dimensional color Doppler ultrasound detected 5 cases with ventricular septal defect,5 cases with doub-le outlet right ventricle,4 cases with tricuspid regurgitation,1 case with transposition of the great arteries and 2 cases with coarctation of the aortic arch.In the diagnosis of CHD by four-dimensional color Doppler ultrasound,there were 6 cases with misdiagnosed CHD,including 5 cases with atrioventricular valve color flow abnormality and 1 case with ven-tricular relaxation abnormality,and there were 3 cases with missed CHD,including 2 cases with transposition of the great arteries and 1 case with ventricular septal defect.Conclusion:Four-dimensional color Doppler ultrasound has higher screening effectiveness for the fetal CHD of the pregnant women during the second and the third trimester of pregnancy.The best examination timing of four-dimensional color Doppler ultrasound for the fetal CHD of the pregnant women is during the second trimester of pregnancy(13-28 gestational weeks),especially during 22-28 gestational weeks,which can reduce the misdiagnosis and missed diagnosis of the fetal CHD.
Congenital heart disease screeningFour-dimensional color Doppler ultrasoundMissed diagnosisMisdi-agnosis
万方数据
维普
