Government Medical College and Hospital Pudukkottai, Pudukkottai, India.
Dr R.K. Hospital for Women and Children, Thanjavur, India.
Fetal Pediatr Pathol. 2022 Jun;41(3):529-532. doi: 10.1080/15513815.2020.1831665. Epub 2020 Oct 16.
Tricuspid valve abnormalities detected in fetal life include Ebstein anomaly and tricuspid valve dysplasia. The differentiation between these 2 entities can sometimes be challenging in the 2nd trimester fetus. We report a case of tricuspid valve dysplasia diagnosed on fetal autopsy. A primigravida was diagnosed at 22 weeks' gestation to have Ebstein anomaly with severe tricuspid regurgitation. There was intra-uterine fetal demise. On fetal autopsy, the tricuspid valve leaflets were not apically displaced and the leaflets were nodular with rolled up edges. This supported a diagnosis of tricuspid valve dysplasia. The difficulties in differentiating Ebstein anomaly from tricuspid valve dysplasia due to inherent limitations in fetal imaging can be resolved by fetal autopsy. Valvular dysplasia will not have apical displacement of the valve leaflets.
胎儿期发现的三尖瓣异常包括 Ebstein 畸形和三尖瓣发育不良。在妊娠中期的胎儿中,这两种情况有时很难区分。我们报告了一例在胎儿尸检中诊断为三尖瓣发育不良的病例。一名初产妇在妊娠 22 周时被诊断为 Ebstein 畸形伴严重三尖瓣反流。出现了宫内胎儿死亡。在胎儿尸检中,三尖瓣瓣叶没有向上移位,瓣叶呈结节状,边缘卷曲。这支持三尖瓣发育不良的诊断。由于胎儿成像的固有局限性,Ebstein 异常与三尖瓣发育不良的鉴别存在困难,可通过胎儿尸检解决。瓣叶发育不良不会出现瓣叶的向上移位。