Hinojosa Cruz Juan Carlos, Luis Miranda Raúl San, Veloz Martínez María Guadalupe, Puello Tamara Edgardo, Arias Monroy Laura Guadalupe, Barra Urrutia Abel, Cetina Camara Nancy del Perpetuo Socorro, del Angel Guadalupe, Gutiérrez González Gladis Alicia, Ramos García Rosa Alicia, Santos Vera Isela
Unidad Médica de Alta Especialidad, Hospital de Ginecología y Obstetricia número 3, Centro Médico La Raza, México, DF.
Ginecol Obstet Mex. 2006 Dec;74(12):645-56.
Fetal heart diseases are increasingly frequent. These are part of birth defects and, therefore, appear in early phases of the gestation. Diagnosis or early detection of functional and structural abnormalities of the heart allows to the obstetrician and the pediatric cardiologist to plan, in a timely manner, the treatment and prenatal and postnatal monitoring with the purpose of preventing complications.
To determine the types and frequencies of heart diseases in pregnancies with high-risk factors.
It was analized an observational, descriptive and retrospective series of cases. From January 2003 to June 2006, fetal echocardiograms were made in women with pregnancies longer than 15 weeks and with high-risk factors. At childbirth was made a cardiovascular evaluation. Analysis was carried out through descriptive statistics.
maternal age average was of 27.3 +/- 6.8 years; gestational age was of 31 +/- 5 weeks. In total, there were carried out 275 fetal echocardiograms (FE) in 208 patients; in 56 of them, was made one fetal ecocardiogram, two in 37 and three in 15. Risk factors of reference to the specialized medical unit were: abnormalities detected through obstetrical ultrasound (35.1%), tachycardia-bradycardia-arrhythmia (29.8%), probable chromosomic anomalies (13.9%), oligohydramnios or polyhydramnios (4.8%), familiar antecedents of congenital heart diseases (3.8%), others (12.6%). Heart disease was diagnosed by fetal echocardiogram in 55 patient (26.4%): unique ventricle (n = 5), hypoplastic right ventricle (n = 3), hypoplastic left ventricle (n = 4), congenital complete heart block (n = 1), Ebstein and dysplasia of the mitral and tricuspid valves (n = 12), tumor (n = 5), ectopia cordis (n = 2), auriculoventricular channel (= 1), supraventricular tachycardia (n = 4), supraventricular extrasystole (n = 3) and other. Diagnosis was confirmed at childbirth in 99.5% of the cases. The treatment was initiated in uterus for arrhythmia and cardiac insufficiency in 19 patients. The patients with high-risk cardiopathy (at birth) were evaluated at beginning through specialized cardiological treatment and then they were transferred to the service of pediatric cardiology.
Frequency of fetal heart diseases in patients with high-risk factors is of 25.4%. In these patients, the fetal echocardiogram (prenatal and postnatal) allows planning the optimal cardiological and obstetric treatment as well as to inform to the relatives.
胎儿心脏病日益常见。这些疾病属于出生缺陷的一部分，因此在妊娠早期就会出现。对心脏功能和结构异常进行诊断或早期检测，有助于产科医生和儿科心脏病专家及时规划治疗方案以及产前和产后监测，以预防并发症。
确定具有高危因素的妊娠中心脏病的类型和发生率。
对一系列观察性、描述性和回顾性病例进行分析。2003年1月至2006年6月，对妊娠超过15周且具有高危因素的孕妇进行胎儿超声心动图检查。分娩时进行心血管评估。通过描述性统计进行分析。
产妇平均年龄为27.3±6.8岁；孕周为31±5周。总共对208例患者进行了275次胎儿超声心动图（FE）检查；其中56例患者进行了1次胎儿超声心动图检查，37例进行了2次，15例进行了3次。转诊至专业医疗单位的高危因素包括：通过产科超声检测到的异常（35.1%）、心动过速-心动过缓-心律失常（29.8%）、可能的染色体异常（13.9%）、羊水过少或羊水过多（4.8%）、先天性心脏病家族史（3.8%）、其他（12.6%）。通过胎儿超声心动图诊断出心脏病的患者有55例（26.4%）：单心室（n = 5）、右心室发育不良（n = 3）、左心室发育不良（n = 4）、先天性完全性心脏传导阻滞（n = 1）、埃布斯坦畸形以及二尖瓣和三尖瓣发育异常（n = 12）、肿瘤（n = 5）、心脏异位（n = 2）、房室通道（= 1）、室上性心动过速（n = 4）、室上性早搏（n = 3）及其他。99.5%的病例在分娩时确诊。19例患者因心律失常和心脏功能不全在子宫内开始治疗。患有高危心脏病（出生时）的患者一开始通过专业心脏病治疗进行评估，然后转诊至儿科心脏病服务部门。
具有高危因素的患者中胎儿心脏病的发生率为25.4%。对于这些患者，胎儿超声心动图（产前和产后）有助于规划最佳的心脏病学和产科治疗方案，并向亲属提供信息。
