Pavlícek J, Gruszka T, Matura D, Petros M, Jabůrek L
Oddelení detské a prenatální kardiologie FN Ostrava.
Ceska Gynekol. 2011 Sep;76(4):306-15.
To study the incidence and significance of fetal tricuspid insufficiency (TI). Evaluation of this incidence of physiological fetuses and of fetuses with congenital heart defects (CHDs). Possibility of prediction the other significant heart pathology or pathology of fetal circulation of fetuses with tricuspid regurgitation (TR).
The study was undertaken between June 2006 and 2010. Fetal echocardiography in the Moravian-Silesian region was mostly performed as a primary screening in the second term of pregnancy. The diameters of the right side of the heart (tricuspid valve annulus, pulmonary valve annulus, surface of the right atrium and diastolic size of the right ventricle) of fetuses with and without TI were evaluated. The pathology of the pregnancy was generally examined and delivery of the newborn was planned. The fetuses with TI were monitored and examined after delivery.
In the observed period, 8 896 pregnancies were examined and we diagnosed 90 significant CHDs. TR occurred in 178 (2%) fetuses. Out of them 20 (11%) fetuses had a defined CHD or significant heart arrhythmia. The most critical CHD with TR was hypoplastic left heart syndrome. TI was insignificant in 158 (89%) fetuses. Progression of the significance of TR with the color Doppler mapping correlated with increased speed of flow. The parameters of the right side of the heart of fetuses with TI do not significantly differ from that of fetuses with a normal tricuspid valve. After the delivery of fetuses with TI, no CHD or chromosomal aberrations were confirmed.
The detection of fetal TI during pregnancy is possible. In some fetuses, there is TI connected with some other CHDs which might be detected by fetal echocardiography what provides us detailed description and diagnosis. TI was always insignificant after a CHD had been eliminated and this TR in the fetus did not significantly affect haemodynamics and did not predict any pathology.
研究胎儿三尖瓣关闭不全（TI）的发生率及意义。评估生理状态胎儿和患有先天性心脏病（CHD）胎儿的TI发生率。预测三尖瓣反流（TR）胎儿是否存在其他重要心脏病变或胎儿循环系统病变的可能性。
研究于2006年6月至2010年期间进行。摩拉维亚-西里西亚地区的胎儿超声心动图检查大多在妊娠中期作为初次筛查进行。对有或无TI的胎儿心脏右侧（三尖瓣环、肺动脉瓣环、右心房表面积及右心室舒张期大小）的直径进行评估。通常对妊娠病理情况进行检查并计划新生儿分娩。对有TI的胎儿在出生后进行监测和检查。
在观察期内，共检查了8896例妊娠，诊断出90例严重CHD。178例（2%）胎儿出现TR。其中20例（11%）胎儿患有明确的CHD或严重心律失常。伴有TR的最严重CHD是左心发育不全综合征。158例（89%）胎儿的TI不严重。彩色多普勒血流图显示TR严重程度的进展与血流速度增加相关。有TI的胎儿心脏右侧参数与三尖瓣正常的胎儿无显著差异。有TI的胎儿出生后，未确诊CHD或染色体异常。
孕期可检测到胎儿TI。在一些胎儿中，TI与其他一些CHD相关，可通过胎儿超声心动图检测到，从而提供详细描述和诊断。排除CHD后，TI通常不严重，胎儿的这种TR对血流动力学无显著影响，也不能预测任何病变。
