胎儿静脉导管异常连接产前超声诊断及预后评估

Prenatal Sonographic Diagnosis and Prognostic Evaluation of Fetal Ductus Venosus-Systemic Venous Shunt

目的探讨胎儿静脉导管异常连接的产前超声诊断价值,评估其预后。资料与方法回顾性分析15例胎儿静脉导管异常连接的产前超声诊断特征(静脉导管异常连接位置、合并畸形类型)及结局。结果静脉导管异常连接位置:静脉导管异常连接于下腔静脉10例,冠状静脉窦3例,肝静脉2例。合并畸形:合并室间隔缺损5例,主动脉缩窄3例,永存左上腔静脉4例,法洛四联症1例,肺动脉闭锁1例,唇腭裂1例,21-三体1例,帆状胎盘1例,孤立性6例。妊娠结局:5例选择终止妊娠,10例出生后4周内静脉导管自发闭合。结论胎儿静脉导管异常连接可合并其他部位畸形,并与染色体异常具有一定的相关性,孤立性静脉导管连接异常预后良好。产前超声对胎儿静脉导管异常连接的诊断及预后评估具有较高的价值,可为产前咨询及产后护理提供重要参考信息。

Purpose To assess the prenatal sonographic diagnosis and prognostic evaluation of fetal ductus venosus-systemic venous shunt.Materials and Methods Fifteen fetus diagnosed as ductus venosus-systemic venous shunt were retrospectively enrolled,and prenatal ultrasound imaging characteristics(including the draining position of the ductus venosus and malformations)and pregnant outcome were further analyzed.Results There were 10 cases with shunt to the inferior vena cava,3 cases to coronary sinus,2 cases to hepatic vein.Moreover,there were 5 cases with ventricular septal defect,3 cases with aortic constriction,4 cases with persistent left superior vena cava,1 case with tetralogy of Fallot,1 case with pulmonary atresia,1 case with cleft lip,1 case with trisomy 21,1 case with velamentous placenta,and 6 cases with ductus venosus-systemic venous shunt.In addition,termination of pregnancy were selected in 5 cases,spontaneous closure of ductus venosus were occurred within 4 weeks after birth in 10 cases.Conclusion Fetal ductus venosus-systemic venous shunt could be associated with malformations and chromosome abnormality.Prenatal ultrasonography in diagnosing ductus venosus-systemic venous shunt possesses high value and prognosis assessment,providing the important information for prenatal counsel and postnatal care.