DeVore G R, Siassi B, Platt L D
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
Am J Obstet Gynecol. 1988 Jul;159(1):129-36. doi: 10.1016/0002-9378(88)90508-x.
Tetralogy of Fallot has increased in incidence during the past decade. Although abnormalities of the four-chamber screening examination of the fetal heart identifies structural anomalies associated with semilunar and atrioventricular valve hypoplasias, the anomalies associated with tetralogy of Fallot are not as readily identifiable from the four-chamber view alone. This study was designed to determine whether aortic root dilatation, commonly observed in the newborn with tetralogy of Fallot, is a marker for tetralogy of Fallot diagnosed in utero. In 45 normal (control) fetuses the biparietal diameter, head circumference, abdominal circumference, and femur length were measured and M-mode measurements were made of the biventricular outer dimension and aortic root dimension. The aortic root dimension from seven fetuses (18, 19, 20, 23, 32, 33, and 34 weeks' gestation) with tetralogy of Fallot was increased in dimension when compared with cardiac (biventricular outer dimension) and noncardiac biparietal diameter, head and abdomen circumferences, and femur length parameters. In conclusion, incorporation of aortic root imaging with the four-chamber view of the fetal heart during a routine screening examination allows for identification of fetuses with tetralogy of Fallot.
在过去十年中，法洛四联症的发病率有所上升。尽管胎儿心脏四腔心筛查检查中的异常可识别与半月瓣和房室瓣发育不全相关的结构异常，但仅从四腔心视图中不太容易识别与法洛四联症相关的异常。本研究旨在确定在患有法洛四联症的新生儿中常见的主动脉根部扩张是否是产前诊断法洛四联症的一个标志物。对45例正常（对照）胎儿测量双顶径、头围、腹围和股骨长度，并对双心室外部尺寸和主动脉根部尺寸进行M型测量。与心脏（双心室外部尺寸）以及非心脏的双顶径、头围、腹围和股骨长度参数相比，7例患有法洛四联症的胎儿（妊娠18、19、20、23、32、33和34周）的主动脉根部尺寸增大。总之，在常规筛查检查中，将主动脉根部成像与胎儿心脏的四腔心视图相结合，能够识别患有法洛四联症的胎儿。
