摘要目的 评价胎儿超声心动图产前诊断先天性心脏病的准确性.方法 回顾2001年1月至2007年12月诊断为先天性心脏病胎儿的超声心动图资料,将产前诊断与胎儿心脏病理诊断或出生后新生儿超声心动图诊断结果进行比较.结果 研究期间共诊断胎儿先天性心脏病113例,初次检查时平均孕周为26.8周.79例(70%)行胎儿心脏病理检查或新生儿超声心动图检查确诊,其中68例产前诊断与产后诊断相符,产前诊断准确率86%.锥干畸形诊断准确率77%(24/31),间隔缺损96%(26/27),瓣膜畸形90%(9/10),单心室畸形83%(5/6).产前假阳性诊断4例,阳性预测值95%(75/79).结论 胎儿超声心动图检查是先天性心脏病产前诊断的有效方法,能够对各种常见类型的先天性心脏病进行准确诊断.完整的分段诊断是降低漏诊及误诊率,提高诊断准确性的关键.

abstractsObjective To evaluate the prenatal diagnostic accuracy of fetal echocardiography for congenital heart defects.Methods Fetal echocardiographic databases from 2001 to 2007 were searched for patients with a prenatal diagnosis of congenital heart defect,medical records were obtained and the prenatal echocardiographic findings were correlated with postnatal echocardiography results or autopsy findings,if the pregnancy was terminated or the fetus died in utero.Results Prenatal diagnosis of congenital heart defects was made in 113 pregnancies at a mean gestational age of 26.8 weeks.Pathology or postnatal echocardiography was available in 79 cases(70%)and the accuracy of prenatal diagnosis was 86%(68/79).Prenatal diagnosis was accurate in 24 of 31 patients(77%)with conotruncal malformations,26 of 27 patients(96%)with septal defects,9 of 10 patients(90%)with valve abnormalities,and 5 of 6 patients(83%)with univentricular hearts.There were 4 false-positives and the positive predictive value was 95%(75/79).Conclusion Fetal echocardiography is a reliable tool for prenatal diagnosis of congenital heart defects despite Limitations for correctly diagnosing some spocific fetal heart defects.