Thammavong Keooudone, Luewan Suchaya, Wanapirak Chanane, Tongsong Theera
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chang Mai, Thailand.
J Ultrasound Med. 2021 Apr;40(4):659-674. doi: 10.1002/jum.15436. Epub 2020 Aug 20.
Insights gained from this review are as follows: (1) Ultrasound is highly effective in early detection of fetal hemoglobin (Hb) Bart disease. (2) The most sensitive parameters in predicting Hb Bart anemia appear to be the cardiac diameter-to-thoracic diameter ratio, middle cerebral artery peak systolic velocity, and placental thickness. (3) Several other ultrasound markers are helpful in increasing specificity, such as hepatosplenomegaly. (4) Hydrops fetalis is not a consequence of heart failure but rather of hypervolemia and high vascular permeability of fetuses, whereas heart failure is a very late consequence of a long-standing overworked heart. (5) Management guidelines for fetuses at risk of Hb Bart disease are proposed.
（1）超声在胎儿血红蛋白Bart病的早期检测中非常有效。（2）预测血红蛋白Bart贫血最敏感的参数似乎是心脏直径与胸廓直径之比、大脑中动脉收缩期峰值流速和胎盘厚度。（3）其他几个超声标志物有助于提高特异性，如肝脾肿大。（4）胎儿水肿不是心力衰竭的结果，而是胎儿血容量过多和血管通透性高的结果，而心力衰竭是长期过度工作的心脏的非常晚期的结果。（5）提出了血红蛋白Bart病风险胎儿的管理指南。
