关键词: 先天性心脏病, 彩色多普勒超声, 静脉导管, 唐氏筛查, 诊断价值

Abstract: Objective To investigate the value of ductus venosus (DV) parameters measured by antenatal color Doppler ultrasound combined with Down’s syndrome screening in the diagnosis of fetal congenital heart disease (CHD).Methods A total of 1689 pregnant women who underwent CHD screening in our hospital from January 2020 to May 2024 were enrolled as subjects. Measurement of DV parameters and Down’s syndrome screening were performed for all subjects, and the detection rate of fetal CHD and diagnostic efficacy were analyzed based on the gold standard of examination results after termination of pregnancy. The fetuses with CHD and those without CHD were compared in terms of DV parameters, alpha-fetoprotein (AFP), unconjugated estriol (uE3), and free β-human chorionic gonadotropin (β-hCG). Results Among the 1689 pregnant women, 60 were diagnosed with fetal CHD based on the gold standard, among whom 55 were detected by DV parameters, with a positive rate of 91.67%, and 52 were detected by Down’s syndrome screening, with a positive rate of 86.67%, while 59 were detected by the combination of DV parameters and Down’s syndrome screening, with a positive rate of 98.33%. The combination of DV parameters and Down’s syndrome screening had significantly higher sensitivity, accuracy, and negative predictive value than each examination alone (P <0.05). The fetuses with CHD had significantly higher values of S/D, PI, PVIV, and PLI than those without CHD (S/D: 5.86±0.85 vs 3.97±0.47, P <0.05; PI: 1.68±0.23 vs 1.05±0.19, P <0.05; PVIV: 1.18±0.22 vs 0.89±0.15, P <0.05; PLI: 1.06±0.19 vs 0.76±0.13, P <0.05). Compared with the fetuses without CHD, the fetuses with CHD had significantly higher levels of AFP (55.65±5.28 ng/mL vs 48.63±4.35 ng/mL, P <0.05) and β-hCG (5.87±1.12 U/L vs 4.23±0.58 U/L, P <0.05) and a significantly lower level of uE3 (1.22±0.23 ng/mL vs 1.61±0.25 ng/mL, P <0.05). Conclusion Antenatal measurement of DV parameters combined with Down’s syndrome screening can improve the accuracy of CHD detection in fetuses, which can help with early intervention and guarantee good prenatal and postnatal care.

Key words: Congenital heart disease, Color Doppler ultrasound, Ductus venosus, Down’s syndrome screening, Diagnostic value