| Objective: To explore the detection rate,differences,echocardiographic characteristics,clinical classification and pregnancy outcome of fetal heart malformations in different age groups of pregnant women,and to provide clinical basis for the monitoring,prevention and control of birth defects.Methods: Retrospective analysis was performed on 124,285 cases receiving prenatal screening in our hospital from January2009 to December 2018,which were divided into 6 groups according to age: ≤19 years old,20-24 years old,25-29 years old,30-34 years old,35-39 years old and ≥40 years old.The detection rate,number and types of fetal cardiac malformations in each group were analyzed.The characteristics of echocardiography,clinical classification and pregnancy outcome of 1,772 fetal heart malformations were analyzed.Results:1.Eight kinds of a total of 740 cases of single deformity,in the majority with ventricular septal defect detection of cases,the rest of the single structure abnormalities including ventricular septal defect in 416 cases,aortic arch narrowed or interrupted aortic arch 119 cases,69 cases of pulmonary stenosis,single atrium or ventricle 49 cases,aorarctia 34 cases,ventricular septal pulmonary atresia with intact ventricular septum 26 cases,ebstein’s anomaly 20 cases,7 cases of coronary artery fistula..2.There were 974 cases with 12 kinds of complex structural malformations(Complex structural deformities are also called complex structural deformities),including 242 cases with tetralogy of fallot and 176 cases with atrioventricular septal defect.The rest of the complex structure abnormalities including129 cases of double outlet of right ventricle,complete transposition or corrective large blood vessels in the main blood vessels,transposition of 104 cases,70 cases of hypoplastic left heart syndrome,18 cases of right ventricular dysplasia syndrome,permanent arterial trunk 66 cases,right-sided aortic arch 52 cases,right isomerism syndrome 48 cases,left isomerism syndrome 15 cases,34 cases of pulmonary atresia with ventricular septal defect,complete anomalous pulmonary venous drainage 12 cases,double aortic arch in 5 cases,aortopulmonary window 3 cases.There were 58 cases of three types of non-structural cardiac malformations,including 31 cases of cardiac occupying malformations,24 cases of fetal arrhythmia,and 3 cases of endocardial elastic fibroplasia.3.The detection number of composite structure malformation in all age groups was higher than that of single structure malformation,The chi-square test was used to compare the detection data of fetal mono-structural malformations and compound structural malformations in all age groups by P=0.214,and the results showed that there was no significant difference between the detection data of fetal mono-structural malformations and compound structural malformations in all age groups(P>0.05).4.Groups of fetal cardiac malformations ultrasonic detection rate,which the highest 19 or less group,20 ～ 24 years old group next,minimum 30 to 34 years old group,the highest detection rate of single deformity were,composite structure deformed the highest detection rate 19 or less group,group of 40 or higher times,composite structure within the same age group of anomaly detection rate were higher than single deformity detection rate.5.Follow-up results and clinical classification: after ultrasonic examination,855 pregnant women chose to induce labor,and 257 induced fetal pathology autopsy;There were 627 births,450 cases of cardiac malformation diagnosed by postnatal ultrasound,and 105 cases of cardiac malformation confirmed by postnatal surgery.Loss of follow-up and labor waiting for 290 cases.Clinical classification: among 1,772 fetuses with heart malformations,634 had complicated heart malformations that could not be cured and had poor prognosis;355 had severe heart malformations that could be cured;306 had heart malformations that needed urgent treatment after birth;and 477 had mild heart malformations.Surgical pathology and post-natal follow-up confirmed 15 cases of missed prenatal ultrasound diagnosis and10 cases of misdiagnosis.Conclusions:1.Fetal heart malformation can be detected in all age groups,so it is recommended that pregnant women of all ages should strictly conduct prenatal III ultrasonic examination,and conduct comprehensive and careful screening for fetal heart malformation.2.The age of pregnant women is too low or too high is not conducive to childbirth,the optimal reproductive age of pregnant women is 25-34 years old,promoting the good birth and good breeding,thus reducing the birth defects of newborns... |
PDF Full Text Request