Clinical Study Of Three-vessel Subsequence Views In Prenatal Screening And Diagnosis Of Fetal Congenital Heart Disease

Objective this study is to investigate the clinical significance of three-vessel subsequence views in prenatal diagnosis of fetal congenital heart disease.Methods from April 2006 to April 2010, three-vessel subsequence views of 2229 normal fetuses and 231 fetuses with congenital heart disease were obtained with Sequoia 512,Voluson 730 and E8 color Doppler ultrasonographic diagnostic system. The diameters of pulmonary artery, ascending aorta and superior vena cava were measured on three-vessel view and ratio of pulmonary artery/ascending aorta, ascending aorta/superior vena cava were calculated.Results The diameters of pulmonary artery, ascending aorta and superior vena cava include 2.5% percentile,5.0% percentile,95.0% percentile, 97.5% percentile were significantly differential among gestation groups (p<0.05) and increasing with gestation week and have straight line correlation with the coefficient correlation being 0.92,0.90 and 0.88 respectively(p<0.05). ratio of pulmonary artery/ascending aorta is stable from 18 gestation week to 38 gestation week and have no straight line correlation (p>0.05), the ratio of ascending aorta/superior vena cava was downtrend with gestation week, but statistics showed no significantly differential (p>0.05). Of 231 consecutive fetuses with CHD,169 were shown to have at least one abnormality on the three-vessel subsequence views, a detection rate of 73%. When septal wall defects were excluded, the detection rate increased to 91%. All cases of transposition of great arteries (TGA), double outlet right ventricle (DORV), aortic stenosis, pulmonary stenosis, truncus arteriosus and ductal aneurysm showed abnormal three-vessel subsequence views. Additionally, some defects had several abnormalities visualized at the three-vessel subsequence views.Conclusion This prospective descriptive study demonstrates that the three-vessel subsequence views has high detection rate in identifying clues for the presence of CHD, especially when excluding septal wall defects and so on. Thus, the three-vessel subsequence views could probably be used as part of routine screening for CHD.