超声心动图对晚孕期胎儿动脉导管早闭及狭窄产前诊断价值评估

The Value of Echocardiography in Prenatal Diagnosis of Premature Closure and Stenosis of Fetal Ductus Arteriosus in Late Pregnancy

目的:评价超声心动图对晚孕期胎儿动脉导管早闭及狭窄产前诊断价值。方法:选择2019年3月~2021年1月经本院胎儿超声心动图诊断为动脉导管早闭或狭窄的42例胎儿资料作为病例组,另选同期在本院接受产前超声检查的正常胎儿51例作为对照组。观察超声心动图对晚孕期胎儿动脉导管早闭及狭窄的诊断结果,比较两组胎儿超声检测参数,并分析相关随访结果。结果:超声心动图诊断动脉导管关闭31例,动脉导管狭窄5例,漏诊6例,诊断符合率为85.71%(36/42)。病例组患儿动脉导管内径小于对照组,肺动脉内径、右室内径、右房内径大于对照组,差异有统计学意义(P<0.05)。3个月后复查超声心动图:患儿肺动脉压力和右心房室内径均恢复正常,2例患儿三尖瓣轻度反流,40例患儿三尖瓣反流消失。结论:超声心动图能够显示晚孕期动脉导管及狭窄的特殊超声征象,对指导临床分娩有重要价值,从而提高围产儿安全。

Objective:To evaluate the value of echocardiography in prenatal diagnosis of premature closure and stenosis of fetal ductus arteriosus in late pregnancy.Methods:42 fetuses with premature closure or stenosis of ductus arteriosus diagnosed by echocardiography in our hospital from March 2019 to January 2021 were selected as the case group,and 51 normal fetuses with prenatal ultrasound in our hospital at the same time were selected as the control group.To observe the results of echocardiography in the diagnosis of premature closure and stenosis of fetal ductus arteriosus in late pregnancy,compare the ultrasonic detection parameters of the two groups of fetuses,and analyze the relevant follow-up results.Results:31 cases of closure of ductus arteriosus,5 cases of stenosis of ductus arteriosus and 6 cases of missed diagnosis were diagnosed by echocardiography.The diagnostic accuracy was 85.71%(36/42).The diameter of ductus arteriosus in the case group was smaller than that in the control group,and the diameter of pulmonary artery,right ventricle and right atrium were larger than those in the control group,with statistical significance(P<0.05).3 months later,reexamination of echocardiography showed that the pulmonary artery pressure and right atrium ventricular diameter of the children returned to normal,2 patients had mild tricuspid regurgitation,and 40 patients had no tricuspid regurgitation.Conclusion:Echocardiography can show the special ultrasonic signs of ductus arteriosus and stenosis in late pregnancy,which is of great value in guiding clinical delivery and improving the safety of perinatal infants.