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胎儿右心增大的超声心动图特征、外科治疗、染色体及预后研究：一篇遵循STROBE规范的文章。

Investigating the characteristics of echocardiogram, surgical treatment, chromosome and prognosis for fetal right heart enlargement: A STROBE-compliant article.

作者信息

Liu Lin, Wang Hong-Dan, Cui Cun-Ying, Yao Hui-Mei, Huang Lei, Li Tao, Fan Tai-Bing, Peng Bang-Tian, Zhang Lian-Zhong

机构信息

Department of Cardiovascular Ultrasound, Henan Provincial People's Hospital, China.

Institute of Medical Genetics, Henan Provincial People's Hospital, China.

出版信息

Medicine (Baltimore). 2018 Nov;97(48):e13307. doi: 10.1097/MD.0000000000013307.

DOI:10.1097/MD.0000000000013307
PMID:30508919
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6283138/
Abstract

The prognosis of right heart enlargement varies according to different etiologies. The purpose of this study was to investigate the characteristics of echocardiogram, surgical treatment, chromosome and prognosis for fetal right heart enlargement.The foetal echocardiogram was performed on 3987 pregnant women, and then 88 fetuses with right heart enlargement were identified. The data about prenatal and postnatal echocardiograms, postnatal cardiac surgical treatment, karyotype analysis and autopsy after induced labor were analyzed in the 88 fetuses.Except the 1111 cases that had loss of follow-up, 2876 cases had complete data. Among the 2876 cases, right heart enlargement was identified in 88 fetuses. Of the 88 fetuses, 15 had total atrioventricular septal defect (unbalanced type: right ventricular dominance), 15 Ebstein's anomaly, 18 fallot tetrad, 14 double outlet right ventricle, 13 total anomalous pulmonary venous drainage, and 13 premature closure of ductus arteriosus. Chromosomal abnormality was found in 12 cases.There are many etiological factors causing right heart enlargement. The prognosis is better in the fetuses with single heart malformation than in the fetuses who have extracardiac malformation or/and chromosomal abnormality besides heart malformation. Fetal echocardiography combined with karyotype analysis can provide important bases for evaluating the prognosis of fetuses with right heart enlargement.

摘要

右心增大的预后因病因不同而有所差异。本研究旨在探讨胎儿右心增大的超声心动图特征、外科治疗、染色体情况及预后。对3987名孕妇进行胎儿超声心动图检查，共识别出88例右心增大胎儿。对这88例胎儿的产前和产后超声心动图、产后心脏外科治疗、核型分析及引产术后尸检数据进行分析。除1111例失访外，2876例有完整数据。在这2876例中，88例胎儿存在右心增大。88例胎儿中，15例为完全性房室间隔缺损（非均衡型：右心室优势型），15例为埃布斯坦畸形，18例为法洛四联症，14例为右心室双出口，13例为完全性肺静脉异位引流，13例为动脉导管早闭。12例发现染色体异常。导致右心增大的病因众多。单纯心脏畸形胎儿的预后优于合并心脏畸形及心外畸形或/和染色体异常的胎儿。胎儿超声心动图联合核型分析可为评估右心增大胎儿的预后提供重要依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/13bc4a09336d/medi-97-e13307-g016.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/0c7bb3564a2e/medi-97-e13307-g010.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/519b4b262a3b/medi-97-e13307-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/6d51900ec00a/medi-97-e13307-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/ee3c24875aa4/medi-97-e13307-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/8de60d626012/medi-97-e13307-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/74a559f535c5/medi-97-e13307-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/ba984d3c73af/medi-97-e13307-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/7a35e0edb621/medi-97-e13307-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/0c7bb3564a2e/medi-97-e13307-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/426e6771eb40/medi-97-e13307-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/394237f5e9d0/medi-97-e13307-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/b8352063dd45/medi-97-e13307-g013.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dcb/6283138/a5eb8ac2ff58/medi-97-e13307-g014.jpg
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