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| Relationship between the fetal heart axis angle monitored by ultrasound during the first trimester of pregnancy and fetal congenital heart disease |
| 1.The First Central Hospital of Baoding, Hebei Province, 071000; 2.The First Hospital of Baoding |
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Abstract To investigate the relationship between the fetal heart axis angle monitored by ultrasound during the first trimester of pregnancy and fetal congenital heart disease. Methods: Fetuses who received fetal nuchal translucency thickness measurement by ultrasound during 11-13+6 gestational weeks were enrolled in this study, which included 32 cases with congenital heart disease in group A and 80 cases without congenital heart disease according to the later followed up results. Fetal cardiac axis was measured on the four-chamber view of the heart based on the guidelines of the International society of ultrasound and obstetrics and gynecology (ISUOG). Then the value of the axial angle for diagnosing fetal congenital heart disease during the first trimester of pregnancy was analyzed. Results: In group A, the three types of heart disease accounted for the highest proportion were TOF (34.4%), VSD (21.9%), and SA and SV (18.8%). The detection rate of two-dimensional ultrasound combined with Doppler blood flow imaging for heart axis was 88.4%, which was significant higher than that (63.4%) of two-dimensional ultrasound alone (P<0.05). The angle of the heart axis of fetus with congenital heart disease was 51.36±11.71°, which was significant higher than that (41.15±10.03°) of normal fetus. The detection rate of abnormal angle of heart axis of fetus with congenital heart disease was 40.6%, which was significant higher than that (1.3%) of normal fetus (all P<0.05). When the heart axis ≥44.74 °, ROC curve found that the AUC, the sensitivity, and the specificity for diagnosing fetal congenital heart disease during the first trimester of pregnancy were 0.777, 75.0%, and 73.7% (95% CI 0.682-0.872), respectively. Conclusion: Two-dimensional ultrasound combined with color Doppler blood flow examination can effectively improve the detection rate of heart axis angle of fetus, and the abnormal heart axis angle of fetus has value for predicting their congenital heart disease.
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