Messing B, Porat S, Imbar T, Valsky D V, Anteby E Y, Yagel S
Department of Obstetrics and Gynecology, Beilinson Medical Center, Rabin Campus, Tel Aviv, Israel.
Ultrasound Obstet Gynecol. 2005 Nov;26(6):606-9; discussion 610. doi: 10.1002/uog.1999.
Tricuspid regurgitation (TR) may accompany various anatomical malformations and/or dysfunction of the fetal right heart. It may also appear in an anatomically healthy heart. With improved ultrasound modalities, more cases than the previously estimated prevalence of fetal TR in the low-risk population are being diagnosed. The objective of this study was to determine the prevalence of mild fetal TR in a low-risk obstetric population.
In 157 low-risk pregnant women (age range, 18-42 years) undergoing both early second-trimester and mid-trimester targeted organ scanning, including complete fetal echocardiography according to the five transverse planes technique, the apical four-chamber view was visualized using gray-scale, color Doppler and spatiotemporal image correlation (STIC) ultrasound modalities, with optimal acquisition parameters.
Mild-to-moderate TR was discovered in the early second-trimester scan in 131/157 (83.4%) fetuses. No cases of cardiac malformation were found. All fetuses showed normal flow in the ductus venosus, including in one case diagnosed with moderate TR. Only in 39 (24.8%) cases was mild TR still evident at the second, mid-trimester scan. Neonatal echocardiography revealed mild TR in eight (5.1%) cases. No cases of chromosomal anomalies were detected.
Mild TR is a benign finding of a temporal nature in early pregnancy.
三尖瓣反流(TR)可能伴随胎儿右心的各种解剖畸形和/或功能障碍。它也可能出现在解剖结构正常的心脏中。随着超声检查方式的改进,低风险人群中胎儿TR的诊断病例比先前估计的患病率更多。本研究的目的是确定低风险产科人群中轻度胎儿TR的患病率。
对157名年龄在18至42岁之间的低风险孕妇进行孕中期早期和孕中期的靶向器官扫描,包括根据五个横切面技术进行完整的胎儿超声心动图检查,使用灰阶、彩色多普勒和时空图像相关(STIC)超声检查方式观察心尖四腔心切面,并采用最佳采集参数。
在孕中期早期扫描中,131/157(83.4%)的胎儿发现有轻度至中度TR。未发现心脏畸形病例。所有胎儿的静脉导管血流均正常,包括1例诊断为中度TR的胎儿。仅在39例(24.8%)中,孕中期第二次扫描时仍有轻度TR。新生儿超声心动图显示8例(5.1%)有轻度TR。未检测到染色体异常病例。
轻度TR是孕早期一种暂时性的良性表现。