태아 심초음파단층상의 임상적 응용 , 선별검사로서의 4-Chamber View의 유용성 = The Clinical Application of Fetal Echocardiography , The Usefulness of Four-Chamber View as a Screening Test

다국어 초록 (Multilingual Abstract)

It is very important to recognize congential heart disease(CHD) at prenatally because CHD is the most common congenital major anomaly in neonates that conributes to signi-ficant perinatal morbidities and increased perinatal death With aid from redent technology, there had been remarkable improvement in diagnostic method for detecting fetal heart disease. The resolution of ultrasonography became markedly improved, Doppler velocimetry and color flow mapping method accesses the evalutaion of fetal circulation along with newly developed method for visualization fo heart structure. In this study ,110 patients with high risk for CHD were selected and fetal echocardio-graphy was performed in period of Jan 1991 through June 1992 at department of obstetrics and gynecology, College of Medicine, Yonsei University. AQxxording to the indication for fetal echocardiography, fetal arrhythmia account for the 21 cases and maternal CHD 16 cases, previous sibling CHD 15cases and extracardiac anomaly 14 cases. The overall incidence of CHD was 9.1%(10/100). All 5 cases with suspected anomalies on the level I scan confirmed to have CHD, where as 20%(1/5) in non-immune hydrops fetalis and 14.3%(3/21) in the fetal arrhythmia. Abnormal 4 chamber view was detected in the most cases with major fetal anomalies 61 cases of 4 chamber view were followed after delivery and diagnostic accuracy of 4 chamber view for detecting CHD were sensitivity 80% specificity 100%, positive predicitive value 100% and negative predictive value 98.2% Four out of 5 cases diagnosed CHDafter the birth showed abnormal 4 chamber view and only 1 cases with TOF showed normal finding From this the incidence of abnormal 4 chamber view in major CHD is very high, there-fore 4 chamber view should be included in screening test for CHD.