The use of echocardiography in fetuses with ultrasound soft markers at first trimester

doi:10.3877/cma.j.issn.1672-6448.2016.11.012

Abstract

Abstract:

Objective

To investigate the value of fetal echocardiography in the diagnosis of congenital heart disease at first trimester in fetuses with ultrasound soft markers.

Methods

Early fetal echocardiography was performed in 133 fetuses with ultrasound soft markers. Special attention was paid at four-chamber view and three vessels and trachea view. Additional fetal echocardiographic planes were also obtained as much as possible. Follow-up was taken 2-4 weeks after cardiac abnormality was suspected. Based on the fingdings of follow-up echocardiography, autopsy was conducted for the fetuses with confirmed diagnosis. On the other hand, routine fetal echocardiography at second trimester and neonatal echocardiography after birth were performed for the fetuses without definite diagnosis.

Results

Four-chamber view and three vessels and trachea view were successfully achieved in 78% (104/133, 78%) and 77% (103/133, 77%) cases, respectively. Ten cases of congenital heart disease (CHD) were suspected by early fetal echocardiography. One case was lost at follow-up and the rest 9 cases were confirmed by autopsy. Among the 9 cases, 7 were diagnosed correctly and 2 were misdiagnosed. Additional 2 cases of CHD were detected during follow-up. The accuracy of early fetal echocardiography in the diagnosis of complex congenital heart disease was 63.6% (7/11, 63.6%).

Conclusion

Early fetal echocardiography is feasible and most complex CHDs can be detected at early stage of pregnancy.

Key words: Echocardiography, Fetus, Congenital heart disease

Qi Pan, Xuedong Deng, Linliang Yin, Jun Zhang, Jianfang Ma, Zhongshan Gou, Zhong Yang. The use of echocardiography in fetuses with ultrasound soft markers at first trimester[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(11): 855-860.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2016.11.012

https://chaosheng.cma-cmc.com.cn/EN/Y2016/V13/I11/855

Figures/Tables 4

References 21

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孕周	例数	Ab	4CV	3VV	LVOT	AA	DA	SVC-IVC
11~11^＋6	13	11（84）	4（31）	6（46）	2（15）	4（31）	8（62）	8（62）
12~12^＋6	45	41（91）	31（69）	33（73）	21（47）	23（51）	34（76）	30（67）
13~13^＋6	75	72（96）	69（92）	64（85）	57（76）	60（80）	66（88）	59（79）
合计	133	124（93）	104（78）	103（77）	80（60）	87（65）	108（81）	97（73）

孕周	例数	Ab	4CV	3VV	LVOT	AA	DA	SVC-IVC
11~11^＋6	13	11（84）	4（31）	6（46）	2（15）	4（31）	8（62）	8（62）
12~12^＋6	45	41（91）	31（69）	33（73）	21（47）	23（51）	34（76）	30（67）
13~13^＋6	75	72（96）	69（92）	64（85）	57（76）	60（80）	66（88）	59（79）
合计	133	124（93）	104（78）	103（77）	80（60）	87（65）	108（81）	97（73）

阳性软指标	先天性心脏病	合并心外畸形	合并染色体异常	妊娠结局
NT	5	4	3	1例失访、1例误诊、4例尸检确诊
TR	1	0	0	尸检证实
DV	1	0	0	尸检证实
两项或以上	3	1	0	2例尸检证实、1例误诊

阳性软指标	先天性心脏病	合并心外畸形	合并染色体异常	妊娠结局
NT	5	4	3	1例失访、1例误诊、4例尸检确诊
TR	1	0	0	尸检证实
DV	1	0	0	尸检证实
两项或以上	3	1	0	2例尸检证实、1例误诊

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