| Objective: To learn the incidence,type and composition of of fetal cardiac malformation in Shijiazhuang and the surrounding areas;To explore the relevance between maternal age, season of conception and fetal cardiac malformations.Methods: A total of 22,588 gestational age 17 to 51 years,gestation age 17 to 51 pregnant women(all were singleton pregancy)as research subjects,who echocardiography in the Second Affiliated Hospital of Hebei Medical University since January 1, 2011 to December 31, 2014.Multiple fetal echocardiography were taken last ultrasound results. exclude individual ultrasound image which in very poor condition or can not properly diagnosed.All fetal echocardiography will be dane by experienced physician in accordance with uniform methods, standards and requirements.The diagnosis of doubtful cases or complex cardiac malformations diagnosed cases were re-checked by at least two of the chief physician at the same time.The 22 588 pregnant women were divided into subjects <25 years, 25-35 years, ≥35 years old three groups,then statistics and compare different age groups the incidence of fetal cardiac malformations. Beside base the difference of conception season, the 22,588 samples divided into spring, summer, autumn and winter four groups,then statistics and compare the incidence of fetal cardiac malformations between the groups.Using GE-Voluson E8、GE-Vivid E9、SIEMENS-Sc2000、Philips-IE33、SIEMENS-Sequoia 512 ultrasonography which equipped with M-mode, two-dimensional ultrasound, pulsed wave Doppler, continuous wave Doppler and color Doppler flow imaging five basic functions.In pregnant women supine or lateral, quiet breathing state, when fetal ultrasonography probe infrequently through the abdominal wall of the fetus’ s heart probed.First, clear the fetal head, spine position.Determine fetal left and right orientation.Above cross-section of the fetal abdomen, according to the stomach bubble transverse plane, liver, abdominal aorta and inferior vena cava and other structures to determine whether fetal organs or situs inversus.Then using 7-slice scanning fetal cardiac malformations, seven facets included: four chamber view, left ventricular outflow tract and aortic long axis, right ventricular outflow tract and pulmonary artery long axis, three vessels- trachea view, aortic arch section, the ductus arteriosus bow section, the superior vena cava, inferior vena cava long axis. At the same time combine with fetal heart stage to analysis fetal CHD. The main observation following: ① apex point, the heart of the position ②cardiothoracic ratio, atrial, ventricular size and wall thickness ③atrioventricular valve position and development of the situation, the atrial septum, atrioventricular septal case ④Atrial and ventricular connection relationship ⑤Ventricular and artery connection relationship Judge the position, direction and aorta, pulmonary ⑥artery blood vessel diameter ratio is normal ⑦Judge atrial and superior vena cava and inferior vena cava and the pulmonary vein connection relationship is normal, judge the inferior vena cava and superior vena cava diameter is normal⑧Aortic valve and pulmonary valve development situation.Then on the basis of the fetal heart pathological anatomy and the ultrasonic diagnostics for fetal heart is normal or abnormal.The above abnormal eight aspects of image, the image and report storage within the workstation.Units of this study is the number of fetus cases. Using EXCEL software to organize data, mapping. Using SPSS13.0 statistical software for analysis of experimental data.Counting data using chi-square test, with P<0.05 as statistically significant differences, P <0.01 was statistically significant.Results:1 Since January 1, 2011 to December 31, 2014,Over the abdomen detailed fetal echocardiography of a total of 22,588 cases in our hospital, of which 1249 cases diagnosed fetal cardiac malformation. Involving a total of 32 categories of disease that not including simple atrial septal defect(secundum) and patent ductus arteriosus. Fetal cardiac malformations incidence 55.29 ‰, where the highest incidence of ventricular septal defect with simple, up 24.04 ‰; followed by endocardial cushion defect, the rate was 3.41 ‰. 2011, 2012, 2013, 2014 the incidence of fetal cardiac malformations were 41.70 ‰, 54.25 ‰, 57.57 ‰, 59.63 ‰.2 Fetal heart defects before ten disease distribution and composition ratio: 542 cases of simple ventricular septal defect(43.39%), 77 cases of endocardial cushion defect(6.16%), single ventricle 76 cases(6.08%), tetralogy of Fallot 76 cases(6.08%), double outlet right ventricle 76 cases(6.08%), transposition of great arteries 45 cases(3.60%), persistent truncus arteriosus 43 cases(3.44%), 33 cases of aortic coarctation(2.64%), hypoplastic left heart 32 cases(2.56%), pulmonary stenosis, 31 cases(2.48%).3 The incidence of fetal cardiac malformations was 59.49 ‰, 51.44 ‰, 79.14 ‰ in the <25 years of age, the age of 25-35, ≥35 years old age three pregnant women groups.Through the chi-square test, differences in the incidence of fetal cardiac malformations among age groups was statistically significant, which ≥35 years age group with a high incidence of fetal cardiac malformations was statistically significant(P <0.05) than the other two groups, the difference was.4 22,588 cases of screening pregnant women, pregnancy season for spring, summer, autumn and winter the incidence of fetal cardiac malformations in turn is 64.01 ‰, 49.42 ‰, 43.84 ‰, 70.11 ‰ Since January 1, 2011 to December 31, 2014.Through the chi-square test, differences in the incidence of fetal cardiac malformations among seasons statistically significant, which in the winter of conception cardiac malformation incidence was significantly higher than the other three groups(P <0.01).Conclusion:1 In recent years,the incidence of fetal cardiac malformation showed a rising trend.2 The top five diseases of fetal cardiac malformations were simple ventricular septal defect, endocardial cushion defect, single ventricle, tetralogy of Fallot, double outlet right ventricle.3 Elderly fertility is highly correlated with congenital heart disease. It is recommended to select the appropriate age pregnancy.4 Winter pregnancy is correlated with fetal cardiac malformations. Preg- gnancy is recommended to choose the appropriate season. |
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