探讨胎儿期诊断为室间隔缺损(VSD)，对胎儿结局的影响。

选择2014年1月1日至2016年11月30日，在南方医科大学附属东莞人民医院，进行系统产前超声检查(Ⅲ级)的23 011例中孕期孕妇的23 041例胎儿为研究对象。对采用胎儿超声心动图(UCG)被诊断为VSD的胎儿，由产科医师综合评估并征询监护人意愿后，决定是否被引产。对部分引产胎儿经监护人同意后进行尸体解剖，对未被引产胎儿，于出生后7 d内进行新生儿UCG检查。根据胎儿尸体解剖和新生儿UCG结果作为确诊VSD的金标准，分析胎儿结局及胎儿UCG诊断VSD的特点。

①胎儿UCG对于本组纳入研究胎儿的VSD的总检出率为0.326%(75/23 041)，其中复杂性VSD检出率为0.182%(42/23 041)，单纯性VSD检出率为0.143%(33/23 041)。②42例复杂性VSD胎儿的引产率为92.9%(39/42)，出生率为4.8%(2/42)，1例胎儿失访。39例引产胎儿中，17例经尸体解剖确认为复杂性VSD，22例未进行尸体解剖。③33例单纯性VSD胎儿的引产率为30.3%(10/33)，出生率为63.6%(21/33)，2例胎儿失访。④对4 369例新生儿于生后7 d内进行UCG检查，新生儿UCG的VSD检出率为1.442%(63/4 369)。其中，采用新生儿UCG诊断2例复杂性VSD，均在产前已被胎儿UCG诊断；诊断61例单纯性VSD，包括产前已被诊断的8例及产前未被诊断的53例；而产前胎儿UCG诊断的5例单纯性VSD，产后新生儿UCG确认并无VSD。

胎儿一旦被诊断为复杂性VSD，则多会被引产，而采取胎儿UCG诊断单纯性VSD则可能被漏诊。胎儿被诊断为单纯性VSD后，亦可能被引产。

To investigate the effects of diagnosis of fetal ventricular septal defect (VSD) on fetal outcomes.

From January 1, 2014 to November 30, 2016, 23 041 fetuses of 23 011 pregnant women in the second trimester of pregnancy who were examined by systematic prenatal ultrasonography (grade Ⅲ) in Dongguan People′s Hospital Affiliated to Southern Medical University, were chosen as research subjects. After the obstetrician comprehensive assessments and consultations with the wishes of the family members, VSD fetus diagnosed by fetal ultrasound cardiography (UCG) were determined whether to be induced or not. Part of aborted fetus were underwent autopsy after obtained the consent of family members, and neonates were examined by UCG within 7 d after birth again. According to the gold standard including fetal autopsy and neonatal UCG results to make a definite diagnosis of VSD, fetal outcomes and the characteristics of fetal UCG in diagnosis of VSD were analyzed.

①The total VSD detection rate by fetal UCG was 0.326%(75/23 041), among them, detection rate of complex VSD was 0.182% (42/23 041), and detection rate of simple VSD was 0.143%(33/23 041). ② Among 42 complex VSD fetuses, the rate of induced labor was 92.9%(39/42), the birth rate was 4.8% (2/42), and 1 fetus lost to follow-up. In 39 fetuses of induced labor, 17 cases were confirmed as complex VSD by autopsy, and no autopsy in the other 22 cases. ③ Among 33 simple VSD fetuses, the rate of induced labor was 30.3% (10/33), the birth rate was 63.6% (21/33), and 2 fetuses lost to follow-up. ④Neonatal UCG examination was performed in 4 369 neonates within 7 days after birth, and the detection rate of VSD in these neonates was 1.442% (63/4 369). Among 63 cases of neonatal VSD, 2 cases of neonatal complex VSD were diagnosed by neonatal UCG, who had been diagnosed in the second trimester of pregnancy by fetal UCG. 61 cases of neonatal simple VSD were diagnosed by neonatal UCG, including 8 cases had been diagnosed in prenatal period, and 53 cases had not been diagnosed in prenatal period; 5 cases of fetal simple VSD diagnosed by fetal UCG were confirmed no VSD by neonatal UCG after birth.

Complex VSD fetuses were more likely to take the measures of inducing labor, simple VSD in fetal period was more likely to be misdiagnosed, and fetuses with simple VSD may also be taken the measures of inducing labor.