From the Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, United Kingdom; the Department of Fetal Medicine, Medway Maritime Hospital, Gillingham, United Kingdom; Unidad Medicina Fetal, Centro Sanitario Virgen del Pilar, San Sebastián, Spain; and the Department of Fetal Medicine, University College Hospital, London, United Kingdom.
Obstet Gynecol. 2011 Jun;117(6):1384-1391. doi: 10.1097/AOG.0b013e31821aa720.
To estimate the potential value of fetal assessment for tricuspid regurgitation at 11-13 weeks of gestation in the prediction of major cardiac defects.
We screened for aneuploidies by measuring fetal nuchal translucency thickness as well as assessing blood flow across the tricuspid valve for evidence of tricuspid regurgitation and in the ductus venosus for evidence of reversed A-wave at 11 0/7 to 13 6/7 weeks of gestation. The estimated performance of different combinations of increased fetal nuchal translucency, tricuspid regurgitation, and ductus venosus reversed A-wave in screening for major cardiac defects was examined.
The study population of euploid fetuses included 85 cases with major cardiac defects and 40,905 with no cardiac defects. Fetal nuchal translucency above the 95th percentile, tricuspid regurgitation, or ductus venosus reversed A-wave was observed in 30 (35.3%), 28 (32.9%), and 24 (28.2%) of the fetuses with cardiac defects, respectively, and in 1,956 (4.8%), 516 (1.3%), and 856 (2.1%) of those without cardiac defects. Any one of the three markers was found in 49 of the fetuses with cardiac defects (57.6%, 95% confidence interval [CI] 47.0-67.6%) and in 3,265 of those without cardiac defects (8.0%, 95% CI 7.7-8.2%).
Assessment of flow across the tricuspid valve improves the performance of screening for major cardiac defects by fetal nuchal translucency and ductus venosus flow.
评估 11-13 孕周胎儿三尖瓣反流在预测重大心脏缺陷方面的潜在价值。
我们通过测量胎儿颈项透明层厚度以及评估三尖瓣和静脉导管的血流来筛查胎儿非整倍体，以评估三尖瓣反流和静脉导管内 A 波反转的证据。检查不同组合的胎儿颈项透明层增厚、三尖瓣反流和静脉导管内 A 波反转在筛查重大心脏缺陷方面的表现。
纳入的正常二倍体胎儿研究人群中，有 85 例存在重大心脏缺陷，40905 例无心脏缺陷。在有心脏缺陷的胎儿中，分别有 30 例（35.3%）、28 例（32.9%）和 24 例（28.2%）存在颈项透明层大于第 95 百分位数、三尖瓣反流或静脉导管内 A 波反转，而在无心脏缺陷的胎儿中，分别有 1956 例（4.8%）、516 例（1.3%）和 856 例（2.1%）存在上述情况。在有心脏缺陷的胎儿中，有 49 例（57.6%，95%置信区间 [CI] 47.0-67.6%）和 3265 例（8.0%，95%CI 7.7-8.2%）的胎儿存在上述三种标志物中的任何一种。
评估三尖瓣血流可提高通过胎儿颈项透明层厚度和静脉导管血流筛查重大心脏缺陷的性能。
