摘要目的 探讨早孕期(11～14+6周)经腹部进行胎儿心脏超声检查的可能性.方法 采用高分辨率腹部探头扫查249例胎儿心脏,观察四腔心切面、左右室流出道切面及三血管切面,记录各个孕周4个切面的显示率.18例透声条件差的孕妇加用经阴道超声检查.结果 249例先心病低危单胎胎儿,227例(91.2％)可显示四腔心,125例(50.2％)可显示左室流出道,102例(40.9％)可显示右室流出道,98例(39.4％)可显示三血管平面.随着孕周的增大,各切面的显示率均呈现增高的趋势,各孕周的切面显示率组间比较差异有统计学意义(P均＜0.05).四腔心观的显示率最高,12周后达95％.13周后,左右室流出道显示率可达85％以上.经阴道超声检查可以提高四腔心的显示率,但是在显示其他切面时,与经腹部超声相比并没有优势.结论 采用高分辨率探头可以观察胎儿早期心脏结构,便于早期发现心脏异常.

abstractsObjective To evaluate the probability of the fetal heart scanning in first trimester(11 -14+6 week) by transabdominal ultrasonography.Methods By using advanced ultrasound machine with high resolution transabdominal probe,249 fetal hearts were scanned.Four chamber view,left and right outflow view,three vessels view were obtained.The successful observation rates of these views under different gestational age were recorded.For 18 pregnant women with suboptimal transabdominal scanning condition,transvaginal scan were supplemented.Results Among 249 singleton fetuses with low risk of congenital heart disease,four chamber view was successfully visualized in 227 (91.2％),left outflow view in 125(50.2％),right outflow view in 102(40.9％),three vessels view in 98(39.4％).The successful observation rate of these four views increased with gestational ages.The successful observation rate of each view in successive gestational age showed remarkable difference (P ＜ 0.05).The four chamber view had the highest successful observation rate with 95％ after 12 weeks.After 13 weeks,left and right outflow views visualizing rate was above 85％.Transvaginal scanning can increase the four chamber view successful observation rate.For observation of other views,transvaginal scanning,however,showed no superior than transabdomial scanning.Conclusions High resolution transabdominal probe can be used to perform the fetal hearts scanning in early trimester.It will benefit to find the fetal heart malformation.