Jiang Zhenlin, Liu Yuhong, Wu Zhongshi, Lu Ting, Tan Ling, Hu Yerong
Department of Cardiovascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Jul 28;45(7):812-818. doi: 10.11817/j.issn.1672-7347.2020.190198.
To explore the method and significance of prenatal counseling in cardiac surgery for fetal congenital heart disease (CHD).
The prenatal counseling should be provided by experienced CHD experts. The preliminary clinical diagnosis based on relevant data was carried out, the prognosis risk for fetal CHD was graded, and the pathophysiological process and potential hazards of the disease were analyzed. The current condition of CHD in the treatment plan, the long-term quality of life, and the special requirements of parturition in place, period and mode were described. A reliable follow-up system of the fetuses was established, the diagnosis after delivery was verified, and surgical treatment was carried out timely.
From January 2016 to December 2018, 225 parents with fetal CHD received prenatal counseling, including 60 fetuses (26.7%) with simple CHD and 165 (73.3%) with complex CHD, among which 59 cases (98.3%) and 93 cases (56.4%) decided to continue the pregnancy, respectively. During the follow-up, 118 fetuses were born, of which 66 infants received surgical treatment within 6 months after birth, 63 infants (95.5%) recovered and 3 infants (4.5%) died. The rest 52 infants continued to be followed up.
The prenatal counseling for fetal CHD can provide the parents a comprehensive medical information about CHD, which is beneficial to making appropriate pregnancy decisions, and can turn the fetuses from unreasonable birth and passive treatment to selective birth and active treatment in CHD.
探讨胎儿先天性心脏病(CHD)心脏手术产前咨询的方法及意义。
由经验丰富的CHD专家进行产前咨询。根据相关资料进行初步临床诊断,对胎儿CHD的预后风险进行分级,并分析疾病的病理生理过程及潜在危害。描述CHD治疗方案中的现状、长期生活质量以及分娩地点、时期和方式的特殊要求。建立可靠的胎儿随访系统,产后核实诊断并及时进行手术治疗。
2016年1月至2018年12月,225例胎儿CHD的父母接受了产前咨询,其中单纯CHD胎儿60例(26.7%),复杂CHD胎儿165例(73.3%),分别有59例(98.3%)和93例(56.4%)决定继续妊娠。随访期间,118例胎儿出生,其中66例婴儿在出生后6个月内接受了手术治疗,63例婴儿(95.5%)康复,3例婴儿(4.5%)死亡。其余52例婴儿继续随访。
胎儿CHD的产前咨询可为父母提供关于CHD的全面医学信息,有利于做出合适的妊娠决策,可使胎儿从不合理出生及被动治疗转变为选择性出生及CHD的主动治疗。