Tansathit Thitinan, Uerpairojkit Boonchai
Department of Obstetrics and Gynecology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2007 Sep;90(9):1738-43.
To quantify the correlation between gestational age and the normal distance between the insertion of the medial leaflets of the mitral valve and tricuspid valve in Thai fetuses.
A prospective study was constructed using an apical 4-chamber view at end diastole to measure the mitral valve-tricuspid valve distance (MTD) in 169 confirmed-dated singleton normal fetuses between 18 and 40 weeks of gestation at King Chulalongkorn Memorial Hospital from August 2005 to July 2006. The recorded distances were plotted against gestational ages. The 5th, 50th, and 95th centile of MTD were calculated and the relationship between MTD and gestational age was determined with regression model. One hundred and forty-seven measurements were validated for analyses.
Regression analysis demonstrated a linear correlation of MTD with gestational age with each increase of 1 week in gestational age, there was an increase of 0.12 mm of MTD (p <. 001). The linear regression curve that correlated MTD with gestational age showed a gradual slope (r = 0.84; p < 0.001). The MTD range from 1.3 to 5.1 mm (mean +/- SD = 2.6 +/- 0.9). A significant difference in MTD was noted on comparing to the data in Western study. Intra-observer reliability was 0.92.
The present findings support the positive correlation between MTD and advancing gestational age. However, clinically significant differences of MTD between the presented population and Caucasian fetuses underline the need for employing a locally derived data on assigning the fetal cardiac abnormality.
量化泰国胎儿的胎龄与二尖瓣和三尖瓣内侧叶附着点之间正常距离的相关性。
采用前瞻性研究,于2005年8月至2006年7月在朱拉隆功纪念医院,利用舒张末期心尖四腔心切面,对169例孕龄在18至40周的确诊单胎正常胎儿测量二尖瓣-三尖瓣距离(MTD)。将记录的距离与胎龄进行绘图。计算MTD的第5、第50和第95百分位数,并通过回归模型确定MTD与胎龄之间的关系。对147次测量结果进行分析验证。
回归分析显示MTD与胎龄呈线性相关,胎龄每增加1周,MTD增加0.12 mm(p <.001)。MTD与胎龄的线性回归曲线呈逐渐上升趋势(r = 0.84;p < 0.001)。MTD范围为1.3至5.1 mm(平均±标准差 = 2.6 ± 0.9)。与西方研究数据相比,MTD存在显著差异。观察者内可靠性为0.92。
本研究结果支持MTD与胎龄增加呈正相关。然而,本研究人群与白种人胎儿之间MTD的临床显著差异表明,在诊断胎儿心脏异常时需要采用本地得出的数据。