Abstract:
Objective To evaluate the diagnostic efficacy of nuchal translucency (NT), tricuspid regurgitation (TR), and ductus venosus (DV) combined with Z-score in fetal congenital heart disease.
Methods A total of 6217 pregnant women who underwent early-trimester neonatal screening at the Affiliated Hospital of Inner Mongolia Medical College from January 2015 to February 2020 were selected as the research subjects. According to the co-confirmation of labor induction and delivery, the fetuses were divided into either an observation group or a control group. The NT, TR, and DV values and the cardiac measurement parameter Z-score of the fetuses were compared between the two groups.
Results The abnormal rates of NT, TR, and DV in the observation group were all higher than those in the control group (χ2=1953.577, 1805.085, and1339.066, respectively, P<0.001). In the prediction with a double-top diameter, the aortic Z score of the observation group was lower than that in the control group (0.012±0.001 vs 0.023±0.002, t=84.259, P=0.000); the pulmonary artery Z score was higher than that of the control group (0.035±0.002 vs 0.025±0.003, t=38.623, P=0.000). In the prediction by femur length, the Z scores of the aorta and pulmonary artery of the fetus in the observation group were both lower than those in the control group (0.022±0.003 vs 0.037±0.004 and 0.031±0.005 vs 0.039±0.003, t=38.172 and 12.474, respectively, P<0.001). In the prediction with actual gestational age, the Z score of the aorta and pulmonary artery of the fetus in the observation group were both lower than those in the control group (0.013±0.001 vs 0.022±0.002 and 0.014±0.002 vs 0.019±0.003, t=68.939 and 19.312, respectively, P<0.001). The diagnostic sensitivity of the combination of NT, TR, and DV values with Z score for fetal congenital heart disease was 93.44%, which was significantly higher than that of any single index alone. The area under the receiver operating characteristic curve (AUC) of the combination of NT, TR, and DV values with Z score in diagnosis of congenital heart disease was 0.892, which was higher than that of any single index alone (95%CI: 0.654~0.912, P<0.001).
Conclusion NT, TR, and DV combined with the fetal heart measurement parameter Z-score has positive diagnostic significance for fetuses with congenital heart disease.
Key words:
Congenital heart disease,
Fetus,
Nuchal translucency,
Tricuspid regurgitation,
Ductus venosus
Haiyan Tian, Mei Xue, Xiao Xiao, Qianrong Liu, Yanan Wang. Diagnostic efficacy of nuchal translucency, tricuspid regurgitation, and ductus venosus combined with Z- score in fetal congenital heart disease[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(05): 405-409.