[Abstract] OBJECTIVE: To investigate the application value of echocardiography in the prenatal diagnosis of fetal simple ventricular septal defect. METHODS: One hundred pregnant women who underwent fetal echocardiography in our obstetrics clinic from January 2012 to January 2014 were selected as the study subjects, and the fetal heart was screened using color Doppler ultrasound diagnostic instrument to observe whether there was echogenic interruption of the septum and blood flow signal through the septum. RESULTS: The number of cases diagnosed as having cardiac disease in the prenatal period was 13, with a confirmation rate of 13.00%, and the number of cases diagnosed in the postnatal period was 15, with a confirmation rate of 15.00%, which were not statistically significant in comparison (p>0.05). Conclusion: Echocardiography has a high diagnostic value in the prenatal diagnosis of fetal simple ventricular septal defect, with a high confirmation rate, easy operation, no radiation damage to the fetus, and no effect on the normal growth and development of the fetus, so it is worth promoting its application in clinical practice.
【Key words】Echocardiography; simple ventricular septal defect; prenatal diagnosis; application value
Simple ventricular septal defect is the most common type of pediatric congenital heart disease, which can exist alone or combined with the occurrence of other cardiac malformations, seriously affecting the physical health and psychological health of the pediatric population, bringing great impact to the pediatric population and causing great hardship and economic pressure to the families of the pediatric population [1]. With the continuous improvement of ultrasound instrument resolution and the accumulation of experience in fetal diagnosis, the clinical application of ultrasound in routine prenatal fetal examination, abnormality monitoring, and malformation screening will become more widespread [2]. In order to investigate the value of the application of echocardiography in the prenatal diagnosis of fetal simple ventricular septal defect, 100 patients were studied and analyzed.
1.Data and methods
1.1 Clinical data
One hundred pregnant women who underwent fetal echocardiography in our obstetrics outpatient clinic from January 2012 to January 2014 were selected as study subjects. The age range of pregnant women was 22 to 39 years old, with an average age of (27.65±3.14) years, and the maternal gestation time range was 18 to 38 weeks, with an average of (26.90±2.85) weeks. Informed consent was obtained from all selected pregnant women, all were singleton pregnancies, and pregnant women with psychiatric disorders of the heart, liver, and kidney were excluded. There was no significant difference between the selected pregnant women (P>0.05), and they were comparable.
1.2 Methods
The instrument selected was a Siemens Sequoia 512 color Doppler ultrasound diagnostic instrument with an abdominal convex array probe with a frequency of 2 to 4 MHz. the fetal heart examination condition was selected, and the speed scale was generally 48 to 2400 px/s. all pregnant women were placed in the supine or lateral position, the probe was placed on the abdominal wall of the pregnant woman for sliding, and the spine of the fetus was swept longitudinally, then the probe was rotated 90° and the fetus was cut transversely The fetus is then rotated 90°, the fetus is cut across the chest to obtain a clear four-chamber view of the heart, the localization is magnified, and the probe is rotated. The internal structures of the fetal heart chambers and the activity of the valves are carefully observed and identified in each section, and the septum is observed for echogenic interruption and septal blood flow.
The site, size, number, speed and direction of the septal flow were recorded in positive cases. In positive cases, the site, size, number, speed and direction of septal flow were recorded. Two senior physicians performed echocardiography on the newborns after delivery to verify and follow up.
1.3 Observation index
To compare the number of cases and the rate of echocardiography for prenatal and postnatal diagnosis of heart diseases.
1.4 Statistical processing
For statistical analysis, spss17.0 software was used to analyze, and ±s was used to express the measurement data, and t-test was used to compare between groups, and p<0.05 was considered statistically significant. < span="">
2, Results
When comparing the diagnosis of heart disease by echocardiography, the number of cases diagnosed with heart disease in the prenatal period was 13, with a diagnosis rate of 13.00%, and the number of cases diagnosed in the postnatal period was 15, with a diagnosis rate of 15.00%, which were not statistically significant (p>0.05), as shown in the following table.
Table 1 Comparison of the diagnosis of heart disease by echocardiography
Number of cases
Number of confirmed cases (cases)
Confirmation rate (%)
Prenatal
100
13
13.00
Postpartum
100
15
15.00
3. Discussion
Congenital heart disease is a congenital malformation caused by abnormal development of the heart and large blood vessels during the fetal period, and in recent years, due to the improvement of diagnosis and external environment and other factors, the detection rate of congenital heart disease in China has shown a significant upward trend, which has a great effect on the late treatment of pediatric patients [3]. This study showed that the number of cases diagnosed prenatally as having heart disease was 13, with a diagnosis rate of 13.00%, and the number of cases diagnosed postnatally was 15, with a diagnosis rate of 15.00%, which were not statistically significant in comparison (p>0.05).
Echocardiography of fetuses with high-risk factors not only allows for correct diagnosis of the fetal condition, effective monitoring and timely treatment, but also timely induction of labor for fetuses with severe congenital malformations, which is good for [4]. A full set of fetal echocardiography should be done for certain mothers with high-risk factors such as family history of congenital heart disease, diabetes mellitus, exposure to teratogenic factors in early pregnancy, fetal growth retardation, fetal arrhythmia, extracardiac malformations, fetal non-immune edema, excessive or too little amniotic fluid, or routine pregnancy tests with four-chambered hearts that are not significant, in order to facilitate the examination of pediatric diseases and to facilitate preoperative determination of the fetal health status, and if problems are found timely treatment or induction of labor, which not only reduces the fetal pain, but also alleviates the problem of economic pressure on the patient due to long-term treatment [5-6]. In recent years, with the development of science, ultrasound technology has a better value for the diagnosis of diseases, and fetal echocardiography has been more widely used in obstetrics and gynecology clinics, and has achieved rapid development [7]. The understanding and technology related to fetal echocardiography in the diagnosis of fetal congenital heart malformations is also becoming more and more perfect, and has shown unique advantages and a higher accuracy rate in the diagnosis of the disease. The mother is placed in the supine or lateral position, and the fetal four-chamber heart section, right and left ventricular outflow tract sections, and aortic arch are carefully observed according to the fetal position. The main structures and connections of the heart were evaluated comprehensively to determine the apical position, atrial body position, connection of the atria with the ventricles and great vessels, the origin and connection status of the arterioles and venous vessels,the position and number of atrioventricular valves, atresia and incomplete closure of the atrioventricular valves, and measurement of the cardiac axis [8]. In order to perform an accurate examination of the fetal simple ventricular septum, the sonographer should have a profound foundation in cardiovascular ultrasound and be able to proficiently master the ultrasound diagnosis of pediatric congenital heart disease, especially the knowledge and techniques of ultrasound diagnosis of complex congenital cardiovascular malformations, and should also master the knowledge and techniques of obstetric ultrasound diagnosis.
In conclusion, echocardiography has a high diagnostic value in the prenatal diagnosis of fetal simple ventricular septal defect, with a high confirmation rate, and is easy to operate, without radiation damage to the fetus, and has no effect on the normal growth and development of the fetus, so it is worth promoting its application in clinical practice.