Mellander Mats
Department of Paediatric Cardiology, The Queen Silvia Children's Hospital, 416 85 Göteborg, Sweden.
Semin Fetal Neonatal Med. 2005 Dec;10(6):586-93. doi: 10.1016/j.siny.2005.08.002. Epub 2005 Oct 4.
Prenatal treatment options for fetal heart disease are still limited but pharmacological treatment of fetal tachyarrhythmias is usually effective. Prenatal catheter interventions are likely to be an option in selected fetal cardiac defects in the future. Delivery should be at a tertiary care centre if the need for immediate neonatal transport is anticipated. When a cardiac problem is diagnosed in a fetus, the parents should be counselled by a paediatric cardiologist specialized in fetal cardiology in close co-operation with the obstetric team. The rate of termination is influenced by gestational age at diagnosis, the severity of the heart defect and the presence of associated malformations. In fetuses with isolated cardiac malformations who are in sinus rhythm with good myocardial function and no or trivial atrioventricular valve regurgitation, the risk of spontaneous intra-uterine death is low. Prenatal echocardiography has the potential to improve postnatal survival in infants with critical heart defects, especially those with duct-dependent systemic or pulmonary circulations.
胎儿心脏病的产前治疗选择仍然有限，但胎儿心律失常的药物治疗通常有效。未来，产前导管介入可能会成为某些特定胎儿心脏缺陷的一种选择。如果预计需要立即进行新生儿转运，分娩应在三级护理中心进行。当胎儿被诊断出心脏问题时，应由专门从事胎儿心脏病学的儿科心脏病专家与产科团队密切合作，为父母提供咨询。终止妊娠的比率受诊断时的孕周、心脏缺陷的严重程度以及是否存在相关畸形的影响。对于患有孤立性心脏畸形、窦性心律、心肌功能良好且无或仅有轻微房室瓣反流的胎儿，自发性宫内死亡的风险较低。产前超声心动图有可能提高患有严重心脏缺陷婴儿的出生后存活率，尤其是那些依赖动脉导管的体循环或肺循环的婴儿。
