O'Kelly Anna C, Sharma Garima, Vaught Arthur Jason, Zakaria Sammy
Department of Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
Department of Medicine, Johns Hopkins University School of Medicine, 4940 Eastern Ave. Bldg 301, Suite 2400, Baltimore, MD, 21224, USA.
Curr Treat Options Cardiovasc Med. 2019 Nov 21;21(11):71. doi: 10.1007/s11936-019-0785-5.
Pregnancy is a time of significant cardiovascular change. Echocardiography is the primary imaging modality used to assess cardiovascular anatomy and physiology during pregnancy. Both two-dimensional (2D) echocardiography and advanced cardiac ultrasound modalities play pivotal roles in identifying and monitoring these changes, especially in women with preexisting or new cardiac disease. This paper reviews the role of echocardiography and advanced cardiac ultrasound during normal pregnancy and pregnancy complicated by hypertensive disorders, valvular disorders, and cardiomyopathy. It also examines the role of echocardiography in guiding decisions about delivery.
The data establishing normal echo parameters during pregnancy are inconsistent. In addition, there is limited research exploring the role of advanced cardiac ultrasound modalities, such as tissue Doppler imaging or speckle tracking echocardiography, in assessing cardiac function during pregnancy. What data there are suggest that these advanced modalities can be used to identify subclinical changes before traditional echocardiography can, and thus have clear utility in identifying early abnormal cardiac responses to pregnancy. Echocardiography is the modality of choice for imaging the heart in pregnant women. Advanced ultrasound modalities increasingly play a role in identifying abnormal adaptations to pregnancy and detecting subclinical changes. This, in turn, can help promote a healthy pregnancy for both mother and fetus.
妊娠期间心血管系统会发生重大变化。超声心动图是评估妊娠期间心血管解剖结构和生理功能的主要影像学检查方法。二维（2D）超声心动图和先进的心脏超声检查方法在识别和监测这些变化中都起着关键作用，尤其是对于患有既往或新发心脏病的女性。本文综述了超声心动图和先进的心脏超声检查在正常妊娠以及合并高血压疾病、瓣膜疾病和心肌病的妊娠中的作用。还探讨了超声心动图在指导分娩决策中的作用。
关于确定妊娠期间正常超声心动图参数的数据并不一致。此外，探索组织多普勒成像或斑点追踪超声心动图等先进心脏超声检查方法在评估妊娠期间心脏功能方面作用的研究有限。现有数据表明，这些先进方法能够在传统超声心动图之前识别亚临床变化，因此在识别心脏对妊娠的早期异常反应方面具有明显的实用价值。超声心动图是孕妇心脏成像的首选检查方法。先进的超声检查方法在识别妊娠异常适应性变化和检测亚临床变化方面发挥着越来越重要的作用。这反过来又有助于促进母婴的健康妊娠。
