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先天性心脏病的产前诊断:当前知识综述

Prenatal diagnosis of congenital heart disease: A review of current knowledge.

作者信息

Bravo-Valenzuela Nathalie Jeanne, Peixoto Alberto Borges, Araujo Júnior Edward

机构信息

Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.

Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil; Mário Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba, MG, Brazil.

出版信息

Indian Heart J. 2018 Jan-Feb;70(1):150-164. doi: 10.1016/j.ihj.2017.12.005. Epub 2017 Dec 16.

Abstract

This article reviews important features to improve the diagnosis of congenital heart disease (CHD) by applying ultrasound in prenatal cardiac screening. As low and high-risk pregnancies for CHD are subject to routine obstetric ultrasound, the diagnosis of structural heart defects represents a challenge that involves a team of specialists and subspecialists on fetal ultrasonography. In this review, the images highlight normal anatomy of the heart as well as pathologic cases consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia, aortic malformations, hypoplastic left ventricle, conotruncal anomalies, tricuspid dysplasia, and Ebstein's anomaly, and univentricular heart, among other congenital cardiovascular defects. Anatomical details of most CHD in fetuses were provided by two-dimensional (2D) ultrasound with higher quality imaging, enhancing diagnostic accuracy in a variety of CHD. Moreover, the accuracy of the cardiac defects in obstetrics ultrasound improves the outcome of most CHD, providing planned delivery, aided genetic counseling, and perinatal management.

摘要

本文综述了通过在产前心脏筛查中应用超声来改善先天性心脏病(CHD)诊断的重要特征。由于CHD的低风险和高风险妊娠都要接受常规产科超声检查,结构性心脏缺陷的诊断是一项挑战,需要胎儿超声检查方面的一组专家和亚专科医生参与。在本综述中,图像突出了心脏的正常解剖结构以及与心脏位置异常和异构、间隔缺损、肺动脉狭窄/闭锁、主动脉畸形、左心室发育不全、圆锥干异常、三尖瓣发育异常和埃布斯坦畸形以及单心室心脏等其他先天性心血管缺陷相符的病理病例。胎儿中大多数CHD的解剖细节由具有更高质量成像的二维(2D)超声提供,提高了对各种CHD的诊断准确性。此外,产科超声中心脏缺陷的准确性改善了大多数CHD的治疗结果,提供了计划分娩、辅助遗传咨询和围产期管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eabd/5903017/9380cd23c03d/gr1.jpg

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