Department of Obstetrics and Gynecology, University of Hallym College of Medicine, Hallym Sacred Heart Hospital, Anyang, South Korea.
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Cardiovasc Ultrasound. 2022 Feb 21;20(1):4. doi: 10.1186/s12947-022-00274-5.
To assess fetal cardiac parameters predictive of postnatal operation type in fetuses with tetralogy of Fallot (TOF).
Echocardiographic data obtained in the second and third trimesters were retrospectively reviewed for fetuses diagnosed with TOF between 2014 and 2018 at Asan Medical Center. The following fetal cardiac parameters were analyzed: 1) pulmonary valve annulus (PVA) z-score, 2) right pulmonary artery (RPA) z-score, 3) aortic valve annulus (AVA) z-score, 4) pulmonary valve peak systolic velocity (PV-PSV), 5) PVA/AVA ratio, and 6) RPA/descending aorta (DAo) ratio. These cardiac parameters were compared between a primary corrective surgery group and a palliative shunt operation followed by complete repair group.
A total of 100 fetuses with TOF were included. Only one neonatal death occurred. Ninety patients underwent primary corrective surgery and 10 neonates underwent a multistage surgery. The PVA z-score, RPA z-score, and RPA/DAo ratio measured in the second trimester and the PVA z-score, RPA z-score, and PVA/AVA raio measured in the third trimester were significantly lower in the multistage surgery group, while the PV-PSV as measured in both trimesters were significantly higher in the multistage surgery group.
Fetal cardiac parameters are useful for predicting the operation type necessary for neonates with TOF.
评估法洛四联症（TOF）胎儿的心脏参数，以预测其出生后的手术类型。
回顾性分析了 2014 年至 2018 年期间在 Asan 医疗中心诊断为 TOF 的胎儿的超声心动图数据。分析了以下胎儿心脏参数：1）肺动脉瓣环（PVA）z 评分，2）右肺动脉（RPA）z 评分，3）主动脉瓣环（AVA）z 评分，4）肺动脉瓣收缩期峰值速度（PV-PSV），5）PVA/AVA 比值，和 6）RPA/降主动脉（DAo）比值。将这些心脏参数在初次根治性手术组和姑息分流术后完全修复组之间进行比较。
共纳入 100 例 TOF 胎儿。仅发生 1 例新生儿死亡。90 例患者接受了初次根治性手术，10 例新生儿接受了多阶段手术。多阶段手术组在第二和第三孕期测量的 PVA z 评分、RPA z 评分和 RPA/DAo 比值均较低，而在两个孕期测量的 PV-PSV 均较高。
胎儿心脏参数可用于预测 TOF 新生儿所需的手术类型。
