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先天性静脉导管缺如胎儿的超声特征及围产期结局

Echographic features and perinatal outcomes in fetuses with congenital absence of ductus venosus.

作者信息

Garcia-Delgado Raquel, Garcia-Rodriguez Raquel, Romero Requejo Azahar, Armas Roca Marta, Obreros Zegarra Luciana, Medina Castellano Margarita, Garcia Hernandez Jose A

机构信息

Department of Obstetrics and Gynecology, Hospital Universitario Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain.

出版信息

Acta Obstet Gynecol Scand. 2017 Oct;96(10):1205-1213. doi: 10.1111/aogs.13176. Epub 2017 Jul 18.

Abstract

INTRODUCTION

The purpose of this study was to describe the echographic features and perinatal outcomes of fetuses with absence of ductus venosus.

MATERIAL AND METHODS

Retrospective review of 10 cases with absence of ductus venosus diagnosed by prenatal ultrasonography between January 2014 and February 2016 at a single referral center. Prenatal findings, umbilical shunting type, perinatal outcomes, and autopsy reports were reviewed.

RESULTS

A total of 11 491 fetuses underwent a first- and second-trimester screening during the study period. Ten cases of absence of ductus venosus were diagnosed. All of the fetuses presented an extrahepatic shunt: three fetuses from the umbilical vein to the right atrium and the seven remaining fetuses from the umbilical vein to the inferior vena cava. Major structural defects and fetal effusions were detected in six fetuses. There were two cases of chromosomal abnormalities. Five patients underwent legal termination of pregnancy and five decided to carry to term. In two of these, the absence of ductus venosus anomaly was isolated and had a normal outcome. In the remaining three cases, a follow up of the children showed a variety of adverse outcomes.

CONCLUSIONS

The absence of ductus venosus is associated with high rates of adverse perinatal outcomes. The prognosis for this group of anomalies depends on the additional findings with targeted ultrasound. This pathology should lead to a detailed anatomical study and affected fetuses should be closely monitored for signs of congestive heart failure.

摘要

引言

本研究的目的是描述静脉导管缺如胎儿的超声特征及围产期结局。

材料与方法

回顾性分析2014年1月至2016年2月在单一转诊中心经产前超声诊断为静脉导管缺如的10例病例。对产前检查结果、脐分流类型、围产期结局及尸检报告进行回顾。

结果

研究期间共有11491例胎儿接受了孕早期和孕中期筛查。诊断出10例静脉导管缺如。所有胎儿均出现肝外分流:3例胎儿为脐静脉至右心房分流,其余7例胎儿为脐静脉至下腔静脉分流。6例胎儿检测到主要结构缺陷和胎儿积液。有2例染色体异常。5例患者接受了合法引产,5例决定继续妊娠至足月。其中2例静脉导管缺如异常为孤立性,结局正常。其余3例对儿童的随访显示有各种不良结局。

结论

静脉导管缺如与围产期不良结局的高发生率相关。这组异常的预后取决于靶向超声的其他检查结果。这种病理情况应进行详细的解剖学研究,对受影响的胎儿应密切监测充血性心力衰竭的体征。

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