Value Of Multi-sections Conjoined Screening And Analysis Of Three Segment In Ultrasonic Diagnosis Of Fetal Heart Conotruncal Defect

Objective To assess the value of multi-sections conjoined screening and analysis of three segment for conotruncal defect(CTD) in fetal heart.Methods Totally,4066 fetuses with cardiac abnormality or high risk factors were retrospectively reviewed from January 2013 to December 2014 in our hospital, which were underwent fetal echocardiography by multi-sections conjoined screening and analysis of three segment. We calculated the accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Youden index in the diagnosis of CTD. All of the cases were contrasted in pathology and echocardiography, and they were used to be karyotype analysis.Results1.Among the 4337 cases,271 cases were lost to follow-up,4066 cases were obtained complete data.2. Among the 4066 cases,89 cases were diagnosed with CTD by prenatal ultrasound, Prenatal ultrasound diagnosis were agreed with follow-up results in 79 cases,10 cases were misdiagnosed,7 cases were not CTD,3 cases were misdiagnosis in conotruncal defect(it belongs to CTD).3.Among the 3977 cases of which were diagnosed with non-CTD,3 cases were misdiagnosed.4.85 cases were made definite diagnosis,22 cases were TOF,30casee were DORV,12 cases were TGA,21 cases were PTA.5. The accuracy rate of ultrasound diagnosis was 88.8%(79/89) of multi-sections conjoined screening and analysis of three segment for conotruncal defect in fetal heart. The sensitivity, specificity, positive predictive value, negative predictive value were 96.5%(82/85),99.8%(3974/3981),92.1%(82/89),99.9%(3974/3977), the Youden index was 0.88.(table 2)6. A total of 3 cases were obtained chromosome karyotype results,2 cases with Trisomy 18,1 case with Trisomy 21.Conclusionl.The accuracy rate of ultrasound diagnosis was 88.8%(79/89) of multi-sections conjoined screening and analysis of three segment for conotruncal defect in fetal heart,th.e sensitivity was 96.5%(82/85),it’s the best way to be prenatal screening.2.1f the fetus was chect by echocardiography befor 13 weeks pregnant.It’s possible for accurate diagnosis in complex congenital heart disease,for example CTD.3. Following up with the heart pathological results of fetus was the best way to discover missed cases in ultrasonic diagnosis and improve the level of ultrasonic diagnosis.