Bravo Arribas Coral, Gámez Alderete Francisco, Pérez Ricardo, Ortiz-Quintana Luis, de León-Luis Juan
Departamento de Obstetricia y Ginecología, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, España.
Ginecol Obstet Mex. 2012 Jun;80(6):425-9.
A case of a fetal isolated aberrant right subclavian artery (ARSA) diagnosis and discuss its clinical implications and the methodology used to assess the fetal right subclavian artery by transabdominal ultrasound in normal cases and those with ARSA is reported.
A 35-year-old pregnant woman in her twentieth week of pregnancy was evaluated at our Fetal Medicine Unit. An isolated ARSA was detected by a transabdominal ultrasound scan of the fetus. The visualization of this anomaly was achieved through an axial view of the fetal thorax, at the level of the three vessels and trachea scanning plane. It was observed that the origin of ARSA from the aortic arch was close to the ductus arteriosus and it followed a retrotracheal course towards the right arm. The described methodology used to assess the right subclavian artery could be useful for prenatal diagnosis in cases of ARSA. Based on this protocol, further studies could be performed to evaluate the utility of ARSA as a sonographic marker for chromosomal abnormality and congenital heart disease. After the diagnosis of an isolated ARSA, the performance of a fetal karyotype test is still debatable.
报告一例胎儿孤立性迷走右锁骨下动脉(ARSA)的诊断病例,并讨论其临床意义以及在正常情况和ARSA病例中经腹超声评估胎儿右锁骨下动脉的方法。
一名35岁妊娠20周的孕妇在我们的胎儿医学科接受评估。通过对胎儿进行经腹超声扫描检测到孤立性ARSA。通过胎儿胸部的轴位视图,在三血管和气管扫描平面水平实现了对该异常的可视化。观察到ARSA起源于主动脉弓,靠近动脉导管,并沿气管后方向右臂走行。所描述的评估右锁骨下动脉的方法可能有助于ARSA病例的产前诊断。基于该方案,可以进行进一步研究以评估ARSA作为染色体异常和先天性心脏病超声标志物的效用。在诊断出孤立性ARSA后,进行胎儿核型检测的必要性仍存在争议。