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胎儿心力衰竭中的多普勒检查

Doppler in fetal heart failure.

作者信息

Huhta James C, Paul James J

机构信息

Perinatal Cardiology, Congenital Heart Institute of Florida, Tampa Bay, Florida, USA.

出版信息

Clin Obstet Gynecol. 2010 Dec;53(4):915-29. doi: 10.1097/GRF.0b013e3181fdffd9.

Abstract

Fetal echocardiography has progressed to be able to diagnose many forms of congenital heart disease (CHD) and to assess the prognosis of cardiac lesions based on their anatomy and presentation in utero. Fetal echocardiography is for pregnancies at risk of structural, functional, and rhythm-related fetal heart disease. Routine obstetrical ultrasound screening is critical in the prenatal detection of fetal heart disease/CHD. With or without CHD, fetal heart dysfunction defined as inadequate tissue perfusion may occur. Perinatal problems other than CHD can also be assessed, such as the effects of noncardiac malformations that affect hemodynamics, that is, twin-twin transfusion. Cardiac rhythm can affect cardiac function and outcome, and prenatal diagnosis can be lifesaving. A tool for the assessment of cardiac function is the Cardiovascular Profile Score that combines ultrasonic markers of fetal cardiovascular unwellness based on univariate parameters, which have been correlated with perinatal mortality. This "heart failure score" could potentially be used in much the same way as and in combination with the biophysical profile score. This study will present a summary of fetal Doppler and its place in the diagnosis and assessment of prognosis of fetal heart failure.

摘要

胎儿超声心动图已发展到能够诊断多种形式的先天性心脏病(CHD),并根据其在子宫内的解剖结构和表现评估心脏病变的预后。胎儿超声心动图适用于有结构、功能和节律相关胎儿心脏病风险的妊娠。常规产科超声筛查在胎儿心脏病/CHD的产前检测中至关重要。无论有无CHD,都可能发生定义为组织灌注不足的胎儿心脏功能障碍。除CHD外,还可评估围产期其他问题,如影响血流动力学的非心脏畸形的影响,即双胎输血。心脏节律会影响心脏功能和结局,产前诊断可能挽救生命。一种评估心脏功能的工具是心血管轮廓评分,它基于单变量参数结合胎儿心血管不适的超声标志物,这些参数与围产期死亡率相关。这种“心力衰竭评分”可能会以与生物物理评分相同的方式并与之结合使用。本研究将概述胎儿多普勒及其在胎儿心力衰竭诊断和预后评估中的地位。

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