【摘要】 目的分析胎儿复杂型先天性心脏病(congenital heart disease,CHD)的诊疗结局,为产前诊断、咨询提供依据。方法收集贵港市妇幼保健院产前诊断中心于2016年1月至2019年7月通过胎儿超声心动图确诊的110例复杂型CHD患儿,并随访至妊娠结局或出生后0.5～4.0年,分析其引产率、活产率、存活儿病死率和手术治疗等结局情况。结果 (1)110例复杂型CHD,产前诊断92例(83.64%);其中治疗性引产78例(84.78%);活产儿25例(22.73%);7 d内死亡7例(28.0%);存活儿中,产前确诊7例(28%)。(2)曾经有CHD生育史的妇女再孕复杂型CHD 1例(0.9%);曾经有先天缺陷儿生育史的妇女再孕复杂型CHD 8例(7.27%),其中6例治疗性引产,2例自然流产。(3)存活儿中,产前诊断组患儿的手术治疗率(66.7%)、存活率(83.3%)均高于产后诊断组,差异没有统计学意义(P>0.05)。结论贵港市的产前干预率较高,需要通过宣教培训等手段提高贵港市产前诊断、咨询覆盖率及水平,从而改进产前干预策略,更利于胎儿复杂型先天性心脏病在围生期及出生后及时手术干预并存活,为产前产后一体化管理创造条件。更多还原

【Abstract】 Objectives To assess the outcomes of clinical management of fetal with complex congenital heart disease (CHD),and to provide evidence for prenatal diagnosis and consultation.Methods We conducted this study at the Prenatal Diagnosis Center of Women′s and Children′s Hospital of Guigang City. We enrolled a total of 110 fetus diagnosed with complex CHD using echocardiogram and followed up till pregnancy outcome or 0.5 to 4 years after delivery. We assessed labor rate,livebirth rate,mortality of live births and surgical treatments of these participants.Results (1)Among the 110 fetus with complex CHD,92(83.64%)were prenatally diagnosed,including 78(84.78%)cases that underwent induced labor. There were a total of 25(22.73%)live births,and 7(28.0%)cases dead within 7 days. Among the cases that survived 7 days after delivery,only 7 cases were diagnosed prenatally.(2)Among the mothers who gave birth to offspring with complex CHD,only 1(0.9%)mother had a history of giving birth to offspring withCHD,and 8(7.27%)mothers had a history of giving birth to offspring with birth defects,6 of these 8 cases underwent induced labor and 2 case were spontaneous abortion.(3)Among the cases that survived 7 days after delivery,66.7% of the prenatally diagnosed cases were performed surgical treatment and 83.3% survived,which were higher than those of postpartum diagnosis with no significant differences(P>0.05).Conclusions The rate of prenatal intervention is high in Guigang City,education and training programs should be conducted to enhance the coverage and effectiveness of prenatal diagnosis and consultation,and to improve prenatal intervention strategies. Therefore,fetus with complex CHDs can receive timely perinatal intervention and may have a better chance of survival. Besides,successful pre-postnatal management can be conducted.更多还原