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孕早期胎儿颈部半透明层增厚时静脉导管血流速度与心脏缺陷的关系

Ductus venosus flow velocities in relation to the cardiac defects in first-trimester fetuses with enlarged nuchal translucency.

作者信息

Haak Monique C, Twisk Jos W W R, Bartelings Margot M, Gittenberger-de Groot Adriana C, van Vugt John M G

机构信息

Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

Am J Obstet Gynecol. 2003 Mar;188(3):727-33. doi: 10.1067/mob.2003.157.

Abstract

OBJECTIVE

Our aim is to study first-trimester ductus venosus (DV) velocities in relation to cardiac abnormalities.

STUDY DESIGN

Ultrasound examination was performed in 85 normal fetuses and 45 fetuses with a nuchal translucency (NT) >95th percentile. Pulsatility index for veins (PIV) and velocity during late diastole (a-V) of the DV were measured and compared with the use of multilevel analysis, between fetuses with a heart defect and those without.

RESULTS

Compared with 85 normal fetuses, the a-V and PIV of the fetuses with NT>95th percentile and normal hearts were decreased and increased, respectively. The a-V and PIV of 11 fetuses with NT>95th percentile and cardiac defects were decreased and increased compared with the 25 fetuses with normal hearts, irrespective of the karyotype. The most common cardiac malformations were septal defects.

CONCLUSION

Fetuses with NT >95th percentile and cardiac defects show markedly changed DV velocities. Because the type of cardiac defects cannot always explain the hemodynamic changes found in these fetuses, some other mechanisms seem to be involved.

摘要

目的

我们的目的是研究孕早期静脉导管(DV)速度与心脏异常的关系。

研究设计

对85例正常胎儿和45例颈项透明层(NT)>第95百分位数的胎儿进行超声检查。测量静脉搏动指数(PIV)和DV舒张末期(a-V)速度,并采用多水平分析比较有心脏缺陷和无心脏缺陷胎儿之间的差异。

结果

与85例正常胎儿相比,NT>第95百分位数且心脏正常的胎儿a-V降低,PIV升高。与25例心脏正常的胎儿相比,11例NT>第95百分位数且有心脏缺陷的胎儿a-V降低,PIV升高,与核型无关。最常见的心脏畸形是间隔缺损。

结论

NT>第95百分位数且有心脏缺陷的胎儿DV速度明显改变。由于心脏缺陷的类型不能总是解释这些胎儿中发现的血流动力学变化,似乎涉及其他一些机制。

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