[Prenatal diagnosis of congenital fetal heart abnormalities in twins by Yagel's heart examination method].

OBJECTIVE:To investigate the value and clinical significance of congenital heart diseases (CHD) detection in twins. METHODS:A total of 1103 twins were included in this study (127 twins were at high risk for CHD). The fetal hearts were scanned by ultrasound using Yagel's heart examination method. Autopsies were done when the pregnancy was terminated. And blood samples from fetal hearts or umbilical veins were used to evaluate fetal chromosomes. A close follow-up was conducted for normal heart cases and another heart examination was done within three months after birth. RESULTS:(1) 12 twins (1.09%, 12/1103) had CHD. Among them, 4 cases were from the high risk for CHD group (33.3%, 4/12), and 8 cases (66.7%, 8/12) were from the low risk pregnancy group. (2) Two twins suffered from the same CHD (one pair were both TOF, and the other pair were both rhabdomyoma). One pair of twins had different abnormalities (one baby was TOF, and the other was duodenal atresia with a normal heart). All three pairs of twins chose termination and autopsies were conducted. Unanimous conclusions between prenatal ultrasound and autopsy were obtained. Nine twins were CHD in one baby and a normal heart in the other baby. Seven of them had the same conclusion after delivery. (3) Two twins with CHD were found with fetal abnormal chromosome. (4) 1091 cases were not found having any abnormality, however, one fetus from one twin pair was diagnosed with ventricular septal defect (VSD) with abnormal chromosome after birth, and one fetus from another twin pair had patency of ductus arteriosus after birth. (5) The sensitivity of Yagel's heart examination was 82.4% and specificity was 100% in twins. CONCLUSION:Yagel's heart examination is an effective and time-saving method to scan fetal hearts in twins.