目的探讨先天性心脏病(CHD)胎儿的妊娠结局,为产前诊断、咨询提供依据。方法收集2011年1月-2012年12月产前诊断为CHD并随访至妊娠结局的胎儿205例,分析胎儿引产率、继续妊娠者围产儿死亡率、存活患儿无症状存活率。结果 CHD胎儿异常核型检出率为36.7%,合并心外异常者占44.4%;复杂型CHD和合并心外异常均可增加胎儿引产率(P〈0.001)及继续妊娠者围产儿死亡率(P〈0.05);合并心外异常可降低患儿无症状存活率(P=0.0058)。结论 CHD胎儿异常核型检出率高;CHD病变类型及合并心外异常均是影响胎儿妊娠结局的危险因素,CHD病变类型较是否合并心外异常对胎儿引产及继续妊娠胎儿围产儿死亡率的影响更大。
Objective To investigate the pregnancy outcome of congenital heart disease(CHD)fetus to provide evidence for prenatal diaognosis and consultation. Methods A retrospective analysis of 205 cases prenatal diagnosed CHD fetus' outcome from January 2011 to December 2012. Analysis the abortion rate,the perinatal mortality in the pregnancies continued,asymptomatic rate in the children survival. Results The abnormal karyotype detection rate in CHD fetus is 36.7%.44.4% CHD fetus had additional extracardiac anomalies. Complex CHD and extracardiac anomalies can significantly increased the abortion rate(P〈0.001)and the perinatal mortality in the pregnancies continued(P〈0.05);extracardiac anomalies can significantly reduced the asymptomatic rate of the children survival(P=0.0058).Conclusions CHD fetal has high abnormal karyotype detection rate. Both the type of CHD and extracardiac anomalies are risk factors for the pregnancy outcome of CHD fetus. Compare with extracardiac anomalies,the type of CHD has even high risk in abortion rate and the perinatal mortality.