胎儿动脉导管收缩及早闭的超声心动图诊断价值

Diagnostic value of echocardiography for fetal ductus arteriosus constriction/closure

目的 研究与分析动脉导管收缩及早闭胎儿的超声心动图特征。方法 2016 年1 月至2018 年2 月于保定市第一中心医院接受产前及产后超声心动图检查和随访确诊的7 例胎儿为动脉导管收缩,2 例胎儿为动脉导管早闭,分析并总结9 例胎儿异常超声心动图的表现及预后结果。结果 9 例动脉导管收缩及早闭胎儿的主要超声表现:右心扩大、主肺动脉内径增宽,动脉导管收缩期及舒张期血流速度增加或无血流通过,三尖瓣反流等。9 例超声心动图诊断动脉导管收缩及早闭的胎儿中1 例于出生5 h 后因呼吸衰竭死亡,其余8 例均顺利产出;产后1 周复查时3 例胎儿超声心动图已正常;其余5 例超声心动图均明显好转。结论 产前超声心动图检查可有效诊断出胎儿动脉导管收缩及早闭,当胎儿右心系统功能紊乱或接近衰竭且胎儿各器官基本成熟时,早期分娩对提高分娩质量,改善预后有较高的临床意义。

Objective To assess the diagnostic value of echocardiography for fetal ductus arteriosus constriction/closure. Methods The data of echocardiography and clinical outcome of 9 fetuses (2 with ductus arteriosus closure and 7 with ductus arteriosus constriction) identified from 864 cases at the First Central Hospital of Baoding between January 2016 and February 2018 were reviewed retrospectively. Results Fetal ductus arteriosus constriction/closure mainly manifested as dilation of the right heart, enlargement of the diameter of the main pulmonary artery, increase or disappearance of the systolic and diastolic blood flow of the ductus, and increased three tricuspid regurgitation. Among the 9 cases of fetal ductus arteriosus constriction/closure, 1 died of respiratory failure 5 hours after birth, and the remaining 8 had successful live birth and underwent echocardiography one week after birth. Among the 8 cases, 3 were normal while the other 5 were significantly improved. Conclusions Prenatal echocardiography can effectively diagnose fetal ductus arteriosus constriction/closure. When the fetus is dysfunctional in the right ventricular system and basically mature in other physiological systems, pre-term delivery is of great clinical value in improving the quality of delivery and prognosis.