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胎儿动脉导管缩窄的超声影像学特征及随访 |
蒋欢,夏红梅 |
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(中国人民解放军陆军军医大学第二附属医院;中国人民解放军陆军军医大学第二附属医院超声科) |
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摘要: |
摘 要:目的 探讨胎儿超声心动图在检测妊娠中晚期胎儿动脉导管提前收缩的临床价值。方法 回顾性分析37例在我院产前诊断为动脉导管提前收缩的超声心动图、临床表现及预后。结果 与胎龄相匹配的正常胎儿比较,动脉导管提前收缩的胎儿均出现右心比例进行性增大,肺动脉增宽 (P﹤0.05),动脉导管内径变细,三尖瓣中度以上反流,动脉导管内呈现花色湍流血流信号,导管收缩期峰值流速增高。37例胎儿随访结果:紧急破腹产8例,其中4例于产后24h内动脉导管闭合, 1例出生后第12天死亡,1例胎儿水肿心衰治愈。19例足月产后随访未见明显异常。1例终止妊娠引产。9例失访。结论 在妊娠晚期胎儿动脉导管提前收缩可导致胎儿右心负荷加重及心脏功能损害,胎儿超声心动图动态监测对于评估胎儿宫内状况及预后具有重要意义。 |
关键词: 胎儿超声心动图 动脉导管缩窄 |
DOI: |
投稿时间:2017-12-01修订日期:2017-12-21 |
基金项目:第三军医大学第二临床医学院临床科研项目 |
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Echocardiography imaging characteristics and follow-up them of ductus arteriosus constriction |
jianghuan,Xiahongmei |
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Abstract: |
Abstract Objective To explore clinical significance of premature constriction of the fetal ductus arteriosus (DA) detected by echocardiography in middle and terminal gestation. Methods Premature constriction of the fetal DA in Thirty-seven fetuses was diagnosed by prenatal echocardiography. The echocardiography, clinical presentation and prognosis were reviewed and analyzed.Results Comparison with normal fetuses with matched gestational ages, narrowing of the inner diameter of the DA was significant, increasing of the diameter of the right atrium (RA), right ventricle (RV) and pulmonary artery (PA) were significant (P﹤0.05), and with moderate to severe tricuspid regurgitation, turbulent flow within the DA with peak systolic velocity increased. Among 8 patients who underwent emergency cesarean section, DA closed within 24h after birth in 4 cases, 1 infant died on the 12th day after birth, 1 case with fetal edema was cured. In addition, there were no obvious abnormalities in 19 cases. 1 case chose termination of pregnancy induced abortion. 11 cases were loss to follow-up. Conclusion Moderate to severe tricuspid regurgitation and right heart load increased were present in fetuses with premature constriction of the DA during terminal gestation. Active monitoring with prenatal echocardiography plays an important role in evaluating fetal intrauterine conditions and prognosis. |
Key words: Fetal echocardiography Ductus arteriosus constriction |
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