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首页> 外文期刊>Indian heart journal >Diagnostic value of fetal echocardiography for congenital heart disease - A single center study
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Diagnostic value of fetal echocardiography for congenital heart disease - A single center study

机译：胎儿超声心动图对先天性心脏病的诊断价值-单中心研究

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Background: Congenital heart disease (CHD) is the most commonbirth defect worldwide, occurring at a rate of 8/1000 births.Despite limitations, fetal echocardiography can identify most of theCHDs, which have major pre and postnatal implications. Studieshave demonstrated that prenatal diagnosis of congenital heart diseaseimproves the immediate outcome following delivery as theywere born at tertiary level hospital.Methodology: This is an observational, prospective study. Ourstudy included 92 pregnant females referred with either maternalindication such as gestational diabetes (88%) or fetal indicationssuch as anomalous fetal anomaly scan, from April 2016 to April2017. Fetal echocardiography was performed for these patientswith gestational age from 18 weeks and above with the use ofS5-1 non-curvilinear echo probe (5.0–1.0 MHz) using Phillips iE33 echocardiography (Netherlands). All the standard views of fetalechocardiography i.e., four chamber view, left ventricular outflowtract (LVOT) view, right ventricular outflow tract (RVOT) view,three vessel view were taken. Repeat postnatal echo was performedfor these patients to confirm the results of fetal echocardiography.True positive (TP), true negative (TN), false positive (FP), andfalse negative (FN) results were calculated, thus giving us valuesof sensitivity and specificity for fetal echocardiography. We usedsymmetric summary receiver-operating curve (SROC) to pool theresult of diagnostic test.Results: Out of 92 patients, 27 were referred in view of maternalindications, while 65 were referred in view of fetal indications,most common being abnormal fetal anomaly scan (78%). Overall,the pooled sensitivity was 78.5% and specificity was 87.8%. Mostcommonly missed CHD on fetal echocardiography was small ventricularseptal defect (VSD) (5%).Conclusion: In conclusion, fetal echocardiography is sensitiveand highly specific investigation modality. It will guide us inproviding appropriate antenatal parent counseling and therebyexplaining the risk and postnatal outcome as well as to identifythe high risk group of fetuses who are suffering from complexcardiac defects and would require tertiary hospital setup fordelivery.
机译：背景：先天性心脏病（CHD）是世界上最常见的出生缺陷，发生率为8/1000例。尽管有局限性，但胎儿超声心动图可以识别大多数CHD，这对出生前后都有重要影响。研究表明，先天性心脏病的产前诊断可改善分娩后在三级医院出生的即时结果。方法：这是一项观察性前瞻性研究。我们的研究纳入了2016年4月至2017年4月期间接受孕产妇指征（例如妊娠糖尿病（88％））或胎儿指征（例如胎儿异常扫描）的92名孕妇。对于这些胎龄在18周及以上的患者，使用Phillips iE33超声心动图（荷兰），使用S5-1非曲线回声探头（5.0–1.0 MHz）对胎儿进行超声心动图检查。进行了所有的心脏超声检查的标准视图，即四腔视图，左心室流出道（LVOT）视图，右心室流出道（RVOT）视图，三支血管视图。对这些患者进行重复的产后回波检查，以确认胎儿超声心动图的结果。计算出真阳性（TP），真阴性（TN），假阳性（FP）和假阴性（FN）的结果，从而为我们提供了敏感性和特异性的值胎儿超声心动图。结果：在92例患者中，有27例因母体适应症而转诊，而65例因胎儿指征而转诊，最常见的是异常胎儿异常扫描（ 78％）。总体而言，合并敏感性为78.5％，特异性为87.8％。胎儿超声心动图最常漏诊的冠心病是小室间隔缺损（VSD）（5％）。结论：总而言之，胎儿超声心动图是灵敏且高度特异性的检查方式。它将指导我们提供适当的产前父母咨询，从而解释风险和出生后结局，并确定患有复杂心脏缺陷且需要三级医院进行分娩的胎儿的高危人群。

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