112例单脐动脉胎儿合并心血管畸形情况及其妊娠结局分析

Analysis of Cardiovascular Malformations and Pregnancy Outcomes in 112 Fetuses of Single Umbilical Artery

【目的】探讨单脐动脉(SUA)胎儿合并心血管畸形的临床特征.【方法】回顾性分析112例SUA胎儿合并心血管畸形的临床资料,结合其超声影像,探讨其妊娠结局.【结果】112例SUA中,单纯性SUA80例(71.4%),合并其他结构畸形32例(28.6%),其中合并心血管系统畸形25例(25/112,22.3%),居首位,18例为心血管严重复杂畸形;25例合并心血管系统畸形中20例引产,5例活产,产前超声及产后超声随访2例为室间隔缺损,3例为室间隔缺损合并左上腔静脉,妊娠期均行染色体检查,未发现异常.伴发的心血管畸形排在前三位的分别是室间隔缺损(17/25,68%),永存左上腔静脉(6/25,24%),永存动脉干(5/25,20%).【结论】SUA合并心血管畸形最常见,畸形种类复杂,孕期特别是孕中期确诊胎儿结构畸形,对于早期干预及减少出生缺陷具有重要意义.

【Objective】To investigate the clinical features of single umbilical artery(SUA)with cardiovascular malformations.【Methods】A total of 112 fetuses with SUA were retrospectively analyzed.Clinical data and ultrasound images were collected to investigate complication with cardiovascular malformations and pregnancy outcomes.【Results】Among the 112 SUA patients,simple SUA occurred in 80 cases(71.4%)and SUA complicated with other structural malformations were seen in 32 cases(28.6%),of which 25 cases(25/32,22.3%)were combined with cardiovascular malformations including 18 cases of severe complex malformations.No abnormal chromosome findings were shown in all 25 cases of SUA with cardiovascular malformations.However,20 cases were induced labor and 5 live births(2 cases of ventricular septal defect and 3 cases of ventricular septal defect with left superior vena cava were diagnosed by prenatal and postnatal ultrasound follow-up).The cardiovascular malformations in the top three places were ventricular septal defect(17/25,68%),persistent left superior vena cava(6/25,24%)and persistent arterial trunk(5/25,20%).【Conclusions】The most common malformations in SUA is cardiovascular malformation,which is so complicated types and poor prognosis.The diagnosis of fetal structural abnormalities during pregnancy,especially in the second trimester,is important for early intervention and reduction of birth defects.