心血管疾病的产前诊断。

Soongswang Jarupim, Sutanthavibul Anuwat, Sunsaneevithayakul Prasert, Thitadilok Wiboolphan, Durongpisitkul Kritvikrom, Laohaprasitiporn Duangmanee, Nana Apichart, Wansanit Kanchana, Punlee Kesaree, Kangkakate Charuwan

Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

J Med Assoc Thai. 2002 Aug;85 Suppl 2:S640-7.

UNLABELLED

Fetal echocardiography is a safe means to obtain reliable anatomical and hemodynamic data of the fetal heart. The procedure is essential for prenatal diagnosis of cardiovascular abnormalities. In addition, fetal echocardiography is useful to follow-up the progression, monitoring during treatment and making a plan of treatment especially in life-threatening cardiac conditions. The objective of this study was to find the distribution of indications for fetal echocardiography, fetal cardiac anomalies detected, outcome of the fetuses and to assess the accuracy of the procedure. A retrospective study was done at Siriraj Hospital, Mahidol University, Bangkok, Thailand. Pregnant women whose fetuses had prenatal echocardiographic data and gave birth from January 1999 to December 2001 were included. The total number of pregnant women was 54 cases. The indications for fetal echocardiography were suspicion of fetal cardiovascular disease by the obstetrician 42.6 per cent, family history of congenital heart diseases 14.8 per cent, multiple organ system anomalies 14.8 per cent, chromosomal anomalies 11.1 per cent, hydrops fetalis 9.3 per cent, maternal systemic diseases 5.6 per cent and previous pregnancy with a dead fetus in utero 1.9 per cent. The gestational age at the time of the first fetal echocardiography ranged from 17 to 39 weeks (median 28 weeks). The number of fetal echocardiography done in each case ranged from 1 to 10 (median 1.4). Prenatal diagnosis of the abnormal cardiovascular system in fetuses was found in 19 cases (35.2%). There were abnormal cardiac anatomies in 42 per cent, cardiac tumors or abnormal masses in 37 per cent and rhythm disturbances in 21 per cent. When compared with postnatal echocardiography and/or autopsy finding, fetal echocardiography had a sensitivity of 100 per cent, specificity of 96.3 per cent and accuracy of 97.8 per cent.

CONCLUSION

Fetal echocardiography has good accuracy in the diagnosis of cardiovascular diseases. Obstetrician's suspicion is important in the prenatal diagnosis of heart disease that would have affected the short and long-term outcome of the fetus.

未标注

胎儿超声心动图是获取胎儿心脏可靠解剖学和血流动力学数据的安全方法。该检查对于心血管异常的产前诊断至关重要。此外，胎儿超声心动图对于追踪病情进展、治疗期间监测以及制定治疗方案很有用，尤其是在危及生命的心脏疾病中。本研究的目的是找出胎儿超声心动图的适应证分布、检测到的胎儿心脏异常、胎儿结局，并评估该检查的准确性。在泰国曼谷玛希隆大学诗里拉吉医院进行了一项回顾性研究。纳入了1999年1月至2001年12月期间胎儿有产前超声心动图数据且已分娩的孕妇。孕妇总数为54例。胎儿超声心动图的适应证包括产科医生怀疑胎儿心血管疾病占42.6%、先天性心脏病家族史占14.8%、多器官系统异常占14.8%、染色体异常占11.1%、胎儿水肿占9.3%、母亲全身性疾病占5.6%以及既往有宫内死胎妊娠史占1.9%。首次胎儿超声心动图检查时的孕周为17至39周（中位数为28周）。每例进行胎儿超声心动图检查的次数为1至10次（中位数为1.4次）。在19例（35.2%）胎儿中发现了心血管系统异常的产前诊断。心脏解剖结构异常占42%，心脏肿瘤或异常肿块占37%，心律失常占21%。与产后超声心动图和/或尸检结果相比，胎儿超声心动图的敏感性为100%；特异性为96.3%；准确性为97.8%。