A review of the diagnostic accuracy of fetal cardiac anomalies.
A review of the diagnostic accuracy of fetal cardiac anomalies.
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DOI：
10.1002/j.2205-0140.2015.tb00024.x
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发表时间：
2015-02-01
影响因子：
--
通讯作者：
Miceli, Frances
中科院分区：
文献类型：
--
作者：
Miceli, Frances
目的：为了评估胎儿心脏畸形的诊断准确性在我们的部门，我们进行了回顾性分析，并比较我们的结果与儿科心脏病专家在相同的情况下。研究方法：从2005年11月至2014年2月，我们的数据库中确定了65例接受中晚期胎儿超声心动图检查的患者。在这6次扫描中，超声检查发现正常，未转诊给儿科心脏病专家。另外6次扫描被诊断为患有复杂先天性心脏病（CHD），伴或不伴额外的心脏异常和/或非整倍体。这6例患者选择终止妊娠，也未接受儿科心脏病专家的检查。其余53例病例转诊至儿科心脏病专家。我们的结果进行了分析，然后与心脏病专家的发现进行了比较。另有3例在我科妊娠期间扫描并诊断为正常，但最终在新生儿期发现患有CHD。结果：对53例心脏病患者的超声表现进行分析，并与心脏科医生的报告进行比较。早期的扫描倾向于描述异常的解剖结构，但显示出不愿意命名任何病理。随着培训和置信水平的提高，我们的部门正确识别了不太复杂的病理，并得到了心脏病专家的确认。结论：在八年的研究期间，我们部门诊断胎儿心脏异常所需的技能，培训和信心水平有所提高，特别是在一些不太复杂的心脏病理方面。然而，更复杂的病理仍然难以评估。
Objectives: In order to assess the diagnostic accuracy of fetal cardiac anomalies in our Department we undertook a retrospective analysis and compared our results with those of the paediatric cardiologists in the same cases. Methods: Sixty-five patients referred for second and third trimester fetal echocardiographic examinations were identified in our database from November 2005 to February 2014. Of these six scans were found to be normal by ultrasound and not referred on to the paediatric cardiologist. An additional six scans were diagnosed to have complex congenital heart disease (CHD) with or without extra cardiac abnormalities and/or aneuploidy. These six patients opted for termination of pregnancy and were also not seen by the paediatric cardiologist. The remaining 53 cases were referred to the paediatric cardiologist. Our results were analysed and then compared to the cardiologist's findings. There were an additional three cases scanned during the pregnancy in our department and diagnosed as normal but ultimately found in the neonatal period, to have CHD. Results: The ultrasound findings of the 53 cases scanned in our department were analysed and compared to the findings in the cardiologist's reports. The earlier scans tended to describe the abnormal anatomy but showed a reluctance to name any pathology. As training and confidence levels increased the less complex pathologies were correctly identified by our department and confirmed by the cardiologist. Conclusion: The skills, training and level of confidence required to diagnose fetal cardiac anomalies in our Department have improved over the eight years of the study period, particularly in regards to some of the less complex cardiac pathologies. However the more complex pathologies remain difficult to assess.