一例伴有环状分流生理改变的严重胎儿埃布斯坦畸形病例中的慢性产前母体高氧血症。

Arunamata Alisa, Axelrod David M, Bianco Katherine, Balasubramanian Sowmya, Quirin Amy, Tacy Theresa A

Department of Pediatrics, Division of Pediatric Cardiology, Stanford University School of Medicine, Palo Alto, CA 94304, USA.

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Stanford University School of Medicine, Stanford, CA 94304, USA.

Ann Pediatr Cardiol. 2017 Sep-Dec;10(3):284-287. doi: 10.4103/apc.APC_20_17.

Perinatal mortality remains high among fetuses diagnosed with Ebstein's anomaly of the tricuspid valve. The subgroup of patients with pulmonary valve regurgitation is at particularly high risk. In the setting of pulmonary valve regurgitation, early constriction of the ductus arteriosus may be a novel perinatal management strategy to reduce systemic steal resulting from circular shunt physiology. We report the use of chronic antepartum maternal oxygen therapy for constriction of the fetal ductus arteriosus and modulation of fetal pulmonary vascular resistance in a late presentation of Ebstein's anomaly with severe tricuspid valve regurgitation, reversal of flow in the ductus arteriosus, and continuous pulmonary valve regurgitation.

在诊断为三尖瓣埃布斯坦畸形的胎儿中，围产期死亡率仍然很高。伴有肺动脉瓣反流的患者亚组风险尤其高。在肺动脉瓣反流的情况下，动脉导管早期缩窄可能是一种新的围产期管理策略，以减少因循环分流生理导致的体循环窃血。我们报告了在一例晚期埃布斯坦畸形伴严重三尖瓣反流、动脉导管血流逆转和持续性肺动脉瓣反流的病例中，使用慢性产前母体氧疗来缩窄胎儿动脉导管并调节胎儿肺血管阻力。