ỨNG DỤNG KĨ THUẬT SIÊU ÂM TIM THAI TRONG SÀNG LỌC, CHẨN ĐOÁN TRƯỚC SINH TẠI CÁC CƠ SỞ Y TẾ CÔNG TỈNH NINH BÌNH

Abstract

Objectives: Assess the current state of medical equipment and prenatal screening services, the current state of knowledge about prenatal screening of medical staff (MS) at public health facilities in Ninh Binh province, evaluate Ultrasound results of screening for fetal heart defects in pregnant women at Ninh Binh Obstetrics and Children's Hospital in 2023. Material and methods: cross-sectional description of the number of ultrasound rooms, ultrasound machines, 150 MS and prospective cross-sectional description of 170 pregnant women. Results: There are no prenatal screening center,  Women and children’s Hospital has an ultrasound room for prenatal screening. 14 ultrasound rooms, Women and children’s Hospital accounts for the highest (35.7%), 19 ultrasound machines, Hospital accounts for the highest (36.8%), 9 4D ultrasound machines. Kim Son Hospital and Nho Quan Hospital only have 2D ultrasound machines. 79.3% were not trained on nuchal translucency (NT), 68.7% were not trained on double test and triple test. Women and children’s Hospital has the highest rate of training on Double test, triple test (47%)(p < 0.05). 85.2% of MS were not trained on congenital hemolysis, 63.3% of MS were not trained on pre-eclampsia screening and 58.7% of MS were not trained on gestational diabetes. Difference in training status of screening tests for pre-eclampsia and gestational diabetes p<0.05, highest in Kim Son (69.2%). 60% of doctors correctly answered that there are 3 times for prenatal screening, and 4% answered that there are 3 times of prenatal screening. Regarding the normal value of NT, 14% of MS answered that they did not know, < 2.5 mm  (48%)and according to percentiles (6.7%). There is a difference between units and groups (p < 0.05), the unit with the highest answer of not knowing is the Women and children’s Hospital (8.1%). The correct answer was highest in the doctor group with normal NT ​​< 2.5mm (40%), < 3mm (40%) ,16.8% calculated by percentile, 4% of doctors do not know  normal NT. The answer of not knowing was highest in the midwifery group (24.1%). The time of NT measurement was different between groups (p < 0.05) 98% of doctors had the correct answer at the time of measurement at 11-13 weeks and 6 days and CRL was 45-84 mm. 2.7% of MS do not know when to measure NT in the highest group of midwives (5.2%) and nurses. Health Centers of Hoa Lu, Tam Diep, Yen Khanh, Yen Mo districts 100% of MS have correct answers: Double test, Triple test and NIPT are screening tests, 10% of MS at Gia Vien district health centers and 4.8% of MS at Women and children’s Hospital incorrect answer, the difference is not statistically significant (p> 0.05). There is a difference in answers in different level groups p < 0.05, 100% of doctors think that Double test  triple test are screening tests. 20% of doctors have correct knowledge about congenital hemolysis, the highest rate of incorrect knowledge is in the nursing group at 97, p> 0.05, 24% answered correctly. Triple test to detect the risk of fetal chromosome abnormalities 13, 18, 21 and neural tube defects.The rate of correct knowledge about when to perform hyperglycemia testing is highest at Gia Vien district health center, accounting for 90%, p < 0,05. Correct knowledge about timing and biochemical substances in preeclampsia screening test was highest in the medical group 46% and 14%, the difference was statistically significant between groups (p < 0.05). 45/170 pregnant woman were 11-13 weeks and 6 days pregnant, 72/170 pregnant  were 18 - 22 weeks pregnant, 53/170 pregnant were 30-32 weeks pregnant. The average age is 29.5 ± 5.7 years old, the most common age group is 25-30 years old (32.9%). Most fetuses have the 4-chamber cross-section examined. At 11-13 weeks and 6 days, the rate of not being able to examine the 3-vessel cross-section, the right ventricular outflow tract cross-section, the left ventricular outflow tract is the highest, the difference is The difference is statistically significant (p < 0.05). 8% of fetal malformations are detected before birth. 8/13 cases of congenital heart disease. 100% of severe congenital heart disease was correctly diagnosed; 33.33% of mild congenital heart disease was misdiagnosed.