国际出生缺陷研究和监测历史(第二部分)

Advance in perinatal management of fetuses with abnormal cardiac physiological shunts

20世纪初,由于医疗和社会条件改善,先天畸形已经成为英美等主要发达国家婴儿死亡的重要因素,人们开始意识到鉴别先天畸形的重要性[1]。因此,欧美一些国家和地区进行了诸多尝试,主要分为两类:一是在医院中建立临床登记体系,负责对院内出生的先天畸形儿进行登记;二是在社区中建立人群登记系统,旨在报告特定城市人群所分娩的畸形儿。

Prior to birth,fetal pulmonary vessels are constricted and fetal lungs and liver are not fully functional.Ductus arteriosus,foramen ovale,and ductus venosus,which are unique cardiovascular structures of fetuses,constitute a parallel circulatory system.A comprehensive understanding of the outcomes of fetuses with abnormal cardiac physiological shunts and improving perinatal management are of great significance in reducing the risk of fetal and neonatal mortality.This review primarily describes the etiology,pathophysiology,treatment strategies,and prognosis of abnormal cardiac physiological shunts in fetuses.