超声筛查胎儿右肺动脉异常起源于升主动脉1例

Ultrasound Screening of Fetal Right Pulmonary Artery Abnormalities Originating from Ascending Aorta:A Case Report

目的探讨产前超声常规检查对胎儿右肺动脉异常起源于升主动脉(anomalous origin of the right pulmonary artery from the ascending aorta,AORPA)的心脏大动脉结构异常特殊超声表现的分析及病例讨论,以提高产前筛查机构对这种特殊的心脏大血管畸形病例的认识和筛查能力。方法选取1例2021年10月28日前往惠东县妇幼保健院的孕妇行孕中期Ⅱ级产前超声检查,检查的过程中发现胎儿存在主肺动脉分叉处未探及右肺动脉分支的异常超声表现。经过多切面连续扫查,发现由升主动脉发出一支血管,血流方向进入右肺,胎儿存在右肺动脉起源异常情况。结果本院诊断为胎儿单纯性右肺动脉异常起源于升主动脉,患者于上级医院进一步检查,结果与本院诊断一致。结论基层产前筛查机构Ⅱ级产前超声能够在中孕期能够对胎儿所存在单侧肺动脉异常起源于主动脉(anomalous origin of pulmonary artery from the ascending aort,AOPA)的心脏大血管畸形进行有效筛查,有利于孕妇选择优生优育、产后及时控制并发症,制订治疗方案,取得手术矫正的良机,对该病的控制与良好预后具有重要的意义。

Objective To explore the analysis and case discussion of the special ultrasonic manifestations of fetal anomalous origin of the right pulmonary artery from the ascending aorta(AORPA)in prenatal ultrasound routine examination,so as to improve the awareness and screening ability of prenatal screening institutions for this special cardiac aortic malformation.Methods A pregnant woman was selected to go to Huidong County Maternal and Child Health Hospital on October 28,2021 for second-trimester level II prenatal ultrasound examination.During the examination,it was found that the fetus had abnormal ultrasonic manifestations of unexplored main pulmonary artery bifurcations and right pulmonary artery branches.After continuous scanning of multiple sections,it was found that a blood vessel emanated from the ascending aorta and entered the right lung in the direction of blood flow.The abnormal origin of the right lung artery was found in the fetus.Results This ultrasound sign was diagnosed as fetal simple right pulmonary artery abnormality originating from the ascending aorta in our department.The patient underwent further examination in a superior hospital,and the results were consistent with the diagnosis in the hospital.Conclusion LevelⅡprenatal ultrasound can effectively screen the large vascular malformations of the heart,such as anomalous origin of pulmonary artery from the ascending aorta(AOPA)in the fetus during the middle pregnancy,which is conducive to pregnant women's choice of good birth and childbirth,timely control of complications after delivery,formulation of treatment plans,and obtaining good opportunities for surgical correction.It is of great significance for the control and good prognosis of the disease.