Clinical application of four-chamber view combined with three-vessel and trachea view color Doppler in screening severe congenital heart malformations in fetuses at 11-13+6 weeks of gestation

doi:10.3877/cma.j.issn.1672-6448.2021.09.005

Abstract

Abstract:

Objective

To investigate the clinical value of four-chamber view combined with three-vessel and trachea (3VT) view color Doppler in screening severe congenital heart malformation in fetuses at 11-13⁺⁶ weeks of gestation.

Methods

From January to December 2018, 9756 pregnant women underwent ultrasound examination at their gestational weeks of 11-13⁺⁶ and 16-24, respectively. Four-chamber view combined with 3VT view color Doppler was used to screen fetal cardiac malformations at 11-13⁺⁶ weeks of gestation. The standardized method of fetal echocardiography was performed at 16-24 weeks of gestation. All neonates and induced fetuses were followed after delivery.

Results

A total of 74 congenital heart malformations were found among the 9756 pregnant women, including 39 severe congenital heart malformations and 35 non-severe cardiac malformations. Thirty-eight (51.4%, 38/74) congenital heart malformations were found at 11-13⁺⁶ weeks of gestation, including 5 non-severe cardiac malformations (14.2%, 5/35), 33 severe congenital heart malformations (84.6%, 33/39).

Conclusion

Most serious fetal heart malformations can be detected when using four-chamber view combined with 3VT view color Doppler, which can provide strong evidence for clinical consultation and prognosis.

Key words: Ultrasonography, prenatal, Fetus, Congenital heart malformation

Guannan He, Jiaxiang Yang, Bei Tang, Jing Zhao, Yan Bai, Xi Chen, Ling Zhang. Clinical application of four-chamber view combined with three-vessel and trachea view color Doppler in screening severe congenital heart malformations in fetuses at 11-13⁺⁶ weeks of gestation[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(09): 841-846.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2021.09.005

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References 14

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心脏畸形类型	例数	NT>95^th	静脉导管频谱		临床结局
心脏畸形类型	例数	NT>95^th	A波缺失	A波反向	活产	引产
室间隔缺损	25	2	0	1	25	0
右锁骨下动脉迷走	4	0	1	0	4	0
右位主动脉弓并左锁骨下动脉迷走	2	0	0	0	2	0
主动脉弓缩窄	4	0	0	1	4	0
合计	35	2	1	2	35	0

心脏畸形类型	例数	NT>95^th	静脉导管频谱		临床结局
心脏畸形类型	例数	NT>95^th	A波缺失	A波反向	活产	引产
室间隔缺损	25	2	0	1	25	0
右锁骨下动脉迷走	4	0	1	0	4	0
右位主动脉弓并左锁骨下动脉迷走	2	0	0	0	2	0
主动脉弓缩窄	4	0	0	1	4	0
合计	35	2	1	2	35	0

心脏畸形类型	例数	NT>95^th	静脉导管频谱		临床结局
心脏畸形类型	例数	NT>95^th	A波缺失	A波反向	活产	引产
房室间隔缺损	9	6	2	1	1	8
永存动脉干	6	3	1	0	0	6
单心房单心室	6	3	0	1	0	6
法洛四联症	2	1	0	0	1	1
右移心	1	0	0	0	1	0
心脏外翻	2	1	2	0	0	2
肺动脉瓣缺如综合征	1	0	1	0	0	1
左心发育不良综合征	2	1	0	0	0	2
右心发育不良综合征	1	0	0	0	0	1
大动脉转位	1	0	0	0	0	1
肺动脉闭锁	1	0	1	0	0	1
主动脉闭锁	1	0	1	0	0	1
合计	33	15	8	2	3	30

心脏畸形类型	例数	NT>95^th	静脉导管频谱		临床结局
心脏畸形类型	例数	NT>95^th	A波缺失	A波反向	活产	引产
房室间隔缺损	9	6	2	1	1	8
永存动脉干	6	3	1	0	0	6
单心房单心室	6	3	0	1	0	6
法洛四联症	2	1	0	0	1	1
右移心	1	0	0	0	1	0
心脏外翻	2	1	2	0	0	2
肺动脉瓣缺如综合征	1	0	1	0	0	1
左心发育不良综合征	2	1	0	0	0	2
右心发育不良综合征	1	0	0	0	0	1
大动脉转位	1	0	0	0	0	1
肺动脉闭锁	1	0	1	0	0	1
主动脉闭锁	1	0	1	0	0	1
合计	33	15	8	2	3	30

心脏畸形类型	四腔心切面超声声像图特征	三血管气管切面超声声像图特征
房室间隔缺损	“十字”交叉消失	2例显示为正常，5例CDFI检测“V”形征象消失，2例主动脉内径明显较主肺动脉内径小
永存动脉干	室间隔连续性中断，CDFI可见双向过隔血流信号	CDFI显示仅见一条大动脉
单心房单心室	仅见一个心房一个心室，CDFI检测，两“平行线”征消失，仅见一组血流信号	1例显示为正常，5例 CDFI检测“V”形征象消失
法洛四联症	室间隔连续性中断，可见双向过隔血流信号	CDFI显示肺动脉内径较主动脉小
右移心	心脏位于右测胸腔	正常
心脏外翻	心脏位于胸腔外	1例显示为正常，1例CDFI检测“V”形征象消失，仅见一条主动脉
肺动脉瓣缺如综合征	右心房室增大，CDFI显示三尖瓣重度反流	肺动脉内径增宽，CDFI检测显示肺动脉内见红蓝交替的往返血流信号
左心发育不良综合征	左心房室明显小于正常	主动脉内径明显较主肺动脉内径小
右心发育不良综合征	右心房室明显小于正常	主肺动脉内径明显较主动脉内径小
大动脉转位	正常	CDFI检测“V”形征象消失
肺动脉闭锁	室间隔连续性中断，CDFI可见双向过隔血流信号	CDFI检测“V”形征象消失，仅见一条主动脉
主动脉闭锁	室间隔连续性中断，CDFI可见双向过隔血流信号	CDFI检测“V”形征象消失，仅见一条肺动脉

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Clinical application of four-chamber view combined with three-vessel and trachea view color Doppler in screening severe congenital heart malformations in fetuses at 11-13⁺⁶ weeks of gestation

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