Akita A, Harima N, Nawata S, Nakata M, Kato H
Department of Obstetrics and Gynecology, Yamaguchi University School of Medicine.
Nihon Sanka Fujinka Gakkai Zasshi. 1991 Dec;43(12):1606-12.
In nine fetuses with ventricular septal defect (VSD), intracardiac blood flow was observed with color Doppler ultrasound. Interventricular shunt velocity, maximum systolic velocity in the ascending aorta and pulmonary artery, trans-atrioventricular blood flow velocity, and the flow pattern in the inferior vena cava were also measured with pulsed Doppler ultrasound. The cardio-thoracic ratio and ejection fraction were measured by B- and M-mood ultrasound. In all four fetuses with isolated VSD a bidirectional shunt was demonstrated. In the three normal developed fetuses time analysis showed a right (RT)-to-left (LT) shunt during systole and a LT-to-RT during diastole with maximum systolic velocities of 61cm/s, 42cm/s and 68cm/s. In the five fetuses with complexed cardiac malformation, two fetuses had a unidirectional shunt and three fetuses had a bidirectional shunt, which was a LT-to-RT during systole and a RT-to-LT during diastole. These studies indicate that although the systolic pressure in the right ventricle is slightly higher than that in the left, the pressure is almost the same in both ventricles. The presence of unidirectional shunting or a different time relationship from that of normal fetuses in bidirectional shunting would necessitate a careful check for other cardiac malformations.
对9例患有室间隔缺损（VSD）的胎儿，采用彩色多普勒超声观察心内血流情况。同时，用脉冲多普勒超声测量室间分流速度、升主动脉和肺动脉的最大收缩期速度、跨房室血流速度以及下腔静脉内的血流模式。通过B超和M超测量心胸比率和射血分数。在所有4例单纯室间隔缺损胎儿中均显示有双向分流。在3例发育正常的胎儿中，时间分析显示在收缩期有右向左分流，舒张期有左向右分流，最大收缩期速度分别为61cm/s、42cm/s和68cm/s。在5例合并心脏复杂畸形的胎儿中，2例有单向分流，3例有双向分流，即收缩期左向右分流，舒张期右向左分流。这些研究表明，虽然右心室的收缩压略高于左心室，但两心室压力几乎相同。单向分流的存在或双向分流时与正常胎儿不同的时间关系需要仔细检查是否存在其他心脏畸形。
