胎儿先天性心脏缺陷与胎盘血管灌注不良的相关性。
The Association of Fetal Congenital Cardiac Defects and Placental Vascular Malperfusion.
机构信息
Division of Maternal Fetal Medicine, Department of OB/GYN, University Hospitals Case Medical Center, Cleveland, Ohio.
Department of Pediatrics, University Hospitals Case Medical Center, Cleveland, Ohio.
出版信息
Pediatr Dev Pathol. 2021 May-Jun;24(3):187-192. doi: 10.1177/1093526620986497. Epub 2021 Jan 25.
OBJECTIVES
Abnormal early angiogenesis appears to impact both placental disorders and fetal congenital heart defects (CHD). We sought to assess the association of placental perfusion defects (PPD) and fetal (CHD).
METHODS
Singleton pregnancies with isolated severe fetal CHD were compared to controls without congenital anomalies or maternal malperfusion (MVM) risk factors. CHD was categorized into group 1: single left ventricle morphology and transposition of the great vessels (TGA) and group 2: single right ventricle and two ventricle morphology. Malperfusion was defined as fetal vascular malperfusion (FVM), MVM, and both FVM and MVM.
RESULTS
PPD was increased for all CHD (n = 47), CHD with or without risk factors, and CHD groups compared to controls (n = 92). Overall CHD cases and CHD with risk factors had an increased risk of FVM (30% and 80% vs 14%), and MVM (43% and 50% vs 21%), respectively. MVM rates were similar in CHD with and without maternal risk factors. FVM (38% vs 14%) and MVM (44% vs 21%) were increased in Group 1. MVM (42% vs 21%) and both FVM and MVM (16% vs 3%) were increased in Group 2.
CONCLUSIONS
PPD risk is increased in severe isolated fetal CHD. The highest risk is seen in fetal CHD with maternal risk factors.
目的
异常的早期血管生成似乎会影响胎盘疾病和胎儿先天性心脏病（CHD）。我们试图评估胎盘灌注缺陷（PPD）和胎儿（CHD）之间的关联。
方法
将孤立性严重胎儿 CHD 的单胎妊娠与无先天性异常或母体灌注不良（MVM）危险因素的对照组进行比较。CHD 分为 1 组：单左心室形态和大血管转位（TGA）和 2 组：单右心室和双心室形态。灌注不良定义为胎儿血管灌注不良（FVM）、MVM 和 FVM 和 MVM 均有。
结果
所有 CHD（n=47）、有或无危险因素的 CHD 以及 CHD 组与对照组（n=92）相比，PPD 增加。总体 CHD 病例和有危险因素的 CHD 发生 FVM 的风险增加（30%和 80%比 14%）和 MVM（43%和 50%比 21%）。有和没有母体危险因素的 CHD 中 MVM 的发生率相似。FVM（38%比 14%）和 MVM（44%比 21%）在第 1 组中增加。MVM（42%比 21%）和 FVM 和 MVM 均有（16%比 3%）在第 2 组中增加。
结论
严重孤立性胎儿 CHD 中 PPD 风险增加。有母体危险因素的胎儿 CHD 风险最高。
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