Wheller J J, Reiss R, Allen H D
Division of Pediatric Cardiology, Ohio State University, Columbus.
Am J Dis Child. 1990 Jan;144(1):49-53. doi: 10.1001/archpedi.1990.02150250059031.
Current ultrasound technology allows for accurate evaluation of the fetal heart. To evaluate the importance and accuracy of the routine clinical use of fetal echocardiography at our center, a consecutive series of 338 fetal cardiac studies of 323 patients was reviewed. Average gestational age was 24 weeks (range, 17 to 39 weeks). Forty-seven (15%) patients with abnormal conditions were detected. The most common indication for fetal cardiac scan was a family history of congenital heart disease (28%). Other indications were maternal diabetes mellitus (25%), fetal dysrhythmia (14%), other major defect (10%), drug exposure (10%), and obstetrician suspicion of fetal congenital heart disease on routine scan (10%). The highest yield of significant abnormal findings was among those referred for dysrhythmia (31%) and obstetrician suspicion of congenital heart disease (29%). Five fetuses with sustained supraventricular tachycardia and hydrops were successfully treated. The combination of fetal bradycardia and structural heart disease was the most ominous finding. Fifteen (4.6%) patients had clear changes in management based on the fetal echocardiogram. Our experience suggests that the routine use of fetal echocardiography is accurate and an important part of the overall management of the pregnancy considered at risk for producing an infant with congenital heart disease.
当前的超声技术能够对胎儿心脏进行准确评估。为了评估胎儿超声心动图在我们中心常规临床应用的重要性和准确性，我们回顾了连续323例患者的338次胎儿心脏检查。平均孕周为24周（范围17至39周）。检测出47例（15%）有异常情况的患者。胎儿心脏扫描最常见的指征是先天性心脏病家族史（28%）。其他指征包括母体糖尿病（25%）、胎儿心律失常（14%）、其他重大缺陷（10%）、药物暴露（10%）以及产科医生在常规扫描时怀疑胎儿患有先天性心脏病（10%）。显著异常发现的最高检出率存在于因心律失常转诊的患者（31%）以及产科医生怀疑患有先天性心脏病的患者（29%）中。5例患有持续性室上性心动过速和水肿的胎儿得到了成功治疗。胎儿心动过缓和结构性心脏病并存是最不祥的发现。15例（4.6%）患者基于胎儿超声心动图在管理上有明确改变。我们的经验表明，胎儿超声心动图的常规应用是准确的，并且是对有生育先天性心脏病患儿风险的妊娠进行全面管理的重要组成部分。
