产前超声诊断先天性心脏病的误漏诊情况及影响因素分析OACSTPCD

Objective To investigate the occurrence of misdiagnosis and missed diagnosis of congenital heart disease(CHD)by prenatal ultrasonography and to analyze its influencing factors.Methods A total of 136 pregnant women who un-derwent fetal CHD screening from May 2019 to February 2023 were selected as the research subjects.All of them underwent prenatal ultrasonography,the abnormal results of prenatal echocardiography were compared with the results of postpartum diagnosis or induction of labor,and the misdiagnosis and missed diagnosis were calculated.Univariate and multivariate lo-gistic regression analyses were used to analyze the factors affecting the misdiagnosis and missed diagnosis of prenatal ultraso-nography in CHD.Results Among 27 patients diagnosed with CHD after labor induction or postpartum,18 cases were com-pletely consistent with prenatal ultrasonography,and the diagnosis coincidence rate was 66.67%.There were 5 cases of missed diagnosis(3 cases of ventricular septal defect,2 cases of right ventricular double outlet)and 4 cases of misdiagnosis(2 cases of right ventricular double outlet and 2 cases of tetralogy of Fallot);the missed diagnosis rate was 3.68%,and the misdiagnosis rate was 2.94%.Age,smoking history or passive smoking,excess body mass gain,insufficient amniotic fluid,scarring of the ab-dominal wall,and little clinical experience of doctors were independent risk factors for misdiagnosis and missed diagnosis of prenatal ultrasonography of CHD(P<0.05,P<0.01).Conclusion Prenatal ultrasonography has good diagnostic value for CHD,but there is misdiagnosis and missed diagnosis.Age,smoking history or passive smoking,excess body weight gain,insuf-ficient amniotic fluid,scarring of the abdominal wall,and little clinical experience of doctors are risk factors for misdiagnosis.Targeted measures should be taken to reduce misdiagnosis and missed diagnosis.