胎儿心律失常的类型及伴发心脏结构异常的临床研究

The clinical research on the types of fetal arrhythmias and concomitant cardiac structural abnormalities

目的 探讨胎儿心律失常的类型及其与伴发心脏结构异常的相关性.方法 对306例孕龄20～ 39周,临床上疑有胎儿心律失常或存在其他异常的孕妇进行彩色多普勒超声心动图检查.结果 在306例研究对象中检测出心律失常者62例,其中期前收缩39例,包括房性期前收缩31例,室性期前收缩8例;心动过速15例,包括窦性心动过速10例,窒上性心动过速5例;心动过缓8例,包括窦性心动过缓5例,房室传导阻滞3例.62例心律失常胎儿中先天性心血管畸形5例.结论 胎儿心律失常为胎儿期最常见的非结构性异常,多不伴有明显心血管畸形或其他胎儿畸形,绝大多数预后良好,持续性胎儿心动过缓多与严重先天性心脏结构缺损有关,应引起医生及孕妇警惕.

Objective To investigate the types of fetal arrhythmias and the correlation between fetal arrhythmias and cardiac structural abnormalities. Methods The data of 306 pregnant women of 20 - 39 weeks gestation, who were suspected of having fetal arrhythmias or some other abnormalities by the color Doppler fetal eehocardiography were analyzed. Results A total of 62 fetuses were revealed with fetal arrhythmias, including 39 cases of premature systole （ 31 for pre- mature atrial beats, 8 for premature ventricular beats） , 15 cases of tachycardia （10 for sinus tachycardia, 5 for the su- praventricular taehyeardia） , 8 cases of bradycardia （5 for sinus bradycardia, 3 for atrioventricular block）. Five fetuses with both cardiac arrhythmias and congenital cardiovascular malformation were revealed. Conclusion The fetal arrhyth- mia is the most common non - structural abnormality without obvious cardiovascular abnormalities or any other abnormali- ties. Most fetuses with arrhythmias can be expected to get good result after proper diagnosis. Doctors and pregnant women should be on guard when persistent fetal bradycardia occurs. Because it is closely related to severe congenital cardiac structural abnormalities.