No abstract

Background: To explore the application value of outflow tract "〥" blood flow in screening fetal cardiac macrovascular structural malformations in early pregnancy.Methods: A total of 3,356 pregnant women who underwent nuchal translucency (NT) screening during early pregnancy in the prenatal diagnosis center of General Hospital of Ningxia Medical University from January 2017 to December 2018 were taken as the research objects, and the fetuses were systematically screened by ultrasound. The display of four chamber cardiac blood flow, X-shaped blood flow of main pulmonary artery, V-shaped blood flow of three vessel trachea and "〥" shaped blood flow of outflow tract were observed and recorded. Fetal autopsy was performed after informed consent of those who terminated pregnancy. Follow up of fetuses and physical examination of newborns.Results: A total of 3,356 cases underwent NT examination in early pregnancy, with an average age of 29.18±4.55 years and crown-rump length (CRL) (6.62±0.89 cm). A total of 66 cases of congenital heart disease (CHD) were detected, and the detection rate was 1.97%. There were 15 cases of conus trunk malformation, accounting for 22.7% of the total incidence of CHD. The sensitivity and the receiver operating characteristic (ROC) curve area (AUC =0.659) of "〥" blood flow of outflow tract in early pregnancy were higher than those of "X" Cross blood flow of main pulmonary artery and "V" blood flow of three vessel trachea.Conclusions: "〥" Doppler superimposed blood flow in the outflow tract has high sensitivity in the screening of fetal cardiac macrovascular malformations, and has good predictive value for CHD. It can be used as a standard to evaluate whether fetal heart is accompanied by conus trunk malformation.

Background: To explore the significance of multiple ultrasonic soft indexes such as Nuchal translucency (NT) in detection of cardiac structural malformations and chromosome abnormalities in fetal systematic screening in the first trimester, and to understand the value of combined transvaginal ultrasound (TVUS) in congenital heart disease (CHD) screening.Methods: A total of 3,356 pregnant women who underwent early NT screening were screened by systematic ultrasound to monitor and evaluate the sensitivity and specificity of NT, tricuspid valve (TV), ductus venosus (DV) in the diagnosis of fetal CHD. According to the different intervals of NT thickening, the patients were divided into four groups, the detection rates of CHD and abnormal karyotypes in each group were compared, and the consistency of transabdominal and combined transvaginal ultrasonography was compared.Results: A total of 3,356 cases of early pregnancy were examined by NT. A total of 66 cases of CHD were detected, and the detection rate was 1.97%. Among the 66 CHD cases, 14 cases underwent chromosome karyotype examination and 12 of those cases had abnormal results. With the increase of NT thickness, the detection rates of cardiac structural abnormalities and chromosomal abnormalities all showed a linear increasing trend. The sensitivity of the NT ≥2.5 mm group was as high as 63.64%, and the ductus venosus α wave (DVα) reverse specificity, and the positive likelihood ratio was 99.57% and 53.41%, respectively. The sensitivity of the 3 indicators combined was 66.67%, which was higher than that of any single index, and the area under the receiver operating characteristic (ROC) curve of these 3 indicators combined was the largest (AUC: 0.86). Seventy patients in total were examined by combined TVUS. There is no statistical difference between the two. Conclusions: A positive linear correlation was found between NT thickness and the detection rate of fetal cardiac structural abnormality and chromosome abnormality. Early pregnancy NT screening combined with TV blood flow spectrum and DV blood spectrum screenings has high specificity and sensitivity in the diagnosis of CHD. Combined transabdominal and TVUS in early pregnancy can reduce the rates of misdiagnosis and missed diagnosis of fetal CHD.

No abstract

No abstract