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目的 探讨超声三步法快速筛查胎儿先天性心脏畸形(CHD)的临床应用价值.方法 回顾性分析75例孕16～28周孕妇的产前产后资料.以胎儿超声心动图为参考标准,评估同期超声三步法对胎儿CHD的诊断效能.结果 75例孕妇中,超声心动图检出CHD胎儿60例;超声三步法检出CHD胎儿57例,漏诊3例,误诊3例.超声三步法快速筛查与胎儿超声心动图具有较好的一致性(Kappa值为0.75,P＜0.01);超声三步法筛查胎儿CHD灵敏度为95％,特异度为80％,准确度为92％,阳性预测值为95％,阴性预测值为80％.超声三步法对胎儿CHD的病因诊断与胎儿超声心动图结果一致者45例,诊断符合率为79％(45/57).结论 超声三步法快速筛查胎儿CHD有较高的灵敏度和准确度,操作简便,可作为胎儿CHD的筛查方法.“,”Objective To study the clinical value of three-step ultrasonography in quickly screening fetal congenital heart defects (CHD).methods The pre-and postnatal data of fetal echocardiography and three-step ultrasonography from 75 pregnant women with 16-28 gestational weeks were retrospectively analyzed.Taking the reports of fetal echocardiography as the reference standards,the diagnostic efficiency of three-step ultrasonography for screening fetal CHD was analyzed.Results Of 75 pregnant women,fetal CHD were reported by echocardiography in 60 cases and by three-step ultrasonography in 57 cases.Three fetuses with CHD missed the diagnosis of CHD and 3 CHD fetuses were misdiagnosed in 75 pregnant women examined by three-step ultrasonography.Both of three-step ultrasonography and fetal echocardiography in screening fetal CHD had a good consistency(Kappa value=0.75,P＜0.01).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of three-step ultrasonography in screening fetal CHD were 95％,80％,92％,95％ and 80％,respectively.The coincidence rate was 79％(45/57) in the CHD diagnosis by three-step ultrasonography and fetal echocardiography.Conclusion Three-step ultrasonography has higher sensitivity and accuracy in quickly screening CHD,which is easy to practice and can be used as a method of screening for fetal CHD.