超声检测胎儿肝静脉频谱在胎儿期外收缩诊断中的价值

Value of fetal hepatic venous Doppler in the diagnosis of fetal extrasystoles

目的评价超声检测胎儿肝静脉频谱在胎儿期外收缩诊断及预后判断中的价值。方法 139例心律不齐胎儿,超声检查其肝静脉和行超声心动图检查,分别于2周后、分娩时和出生后3 d内复查。结果超声检查示124例(89.8%)胎儿室上性期外收缩,15例(10.2%)室性期外收缩;分娩时室上性期外收缩14例(11.3%),室性期外收缩3例(20.0%);出生后3d内16例心律恢复正常,1例室上性期外收缩发展为室上性心动过速。结论超声检测胎儿肝静脉频谱可鉴别室上性期外收缩与室性期外收缩,室性期外收缩更易在整个妊娠期持续存在,只有极少数期外收缩病例发展为心动过速或伴有先天性心脏畸形。

O bjective To evaluate the value of fetal hepatic venous Doppler in the diagnosis of fetal extrasystoles. Methods A Total of 139 fetuses with arrhymia were performed echocardiography and their Hepatic veins were examined. The rhythm of heart were recorded in different periods of time including two weeks after examination,during the labor and neonatal period. Results For venous Doppler examination,124（89.8%）of the fetuses showed signs of supraventricular extrasystoles （SVES）and 15（10.2%）had ventricular extrasystoles（VES）. SVES persisted until labor and delivery in 14（11.3%）fetuses and VES persisted in three （20 . 0%）. Sixteen fetuses with extrasystoles during labor and delivery restored the normal heart rhythm within 3 days. In one fetus, the supraventricular extrasystoles was developed to supraventricular tachycardia. Conclusion Hepatic venous Doppler can differentiate SVES from VES. VES persists throughout pregnancy more often. Only few cases with extrasystole will be developed to tachycardia or accompanied by congenital heart malformation.