Department of Obstetrics and Gynecology, Christophorus-Kliniken GmbH, Coesfeld, Germany.
Department of Maternal-Fetal Medicine, Institute Clinic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
Arch Gynecol Obstet. 2022 Dec;306(6):1885-1890. doi: 10.1007/s00404-022-06484-6. Epub 2022 Mar 17.
To compare the fetal brain structures assessed in routine sonographic scans during the second and third trimesters in fetuses with and without congenital heart disease (CHD).
This is a retrospective cross-sectional single-center study. We measured the head circumference (HC), the transversal diameter of the cerebellum (TCD) and the sizes of the cisterna magna (CM), the cavum septi pellucidi (CSP) and the posterior ventricles (PV) between 20 and 41 weeks of gestation. We compared 160 fetuses with CHD (case group) to 160 fetuses of normal pregnancies (control group). Every patient was matched with a control, considering the gestational age at which the ultrasound was performed. We divided the CHD group into 3 subgroups: retrograde flow in the aortic arch (group 1), right heart anomaly with the antegrade flow in the aortic arch (group 2) and other CHDs with the antegrade flow in the aortic arch (group 3).
The mean width of the PV was larger in fetuses of groups 1 and 3 in comparison to the control group (P < 0.001, P = 0.022; respectively). We found that the APGAR score at 5 min (P < 0.001, P < 0.001; respectively) and gestational age at delivery (P = 0.006, P = 0.001; respectively) were inferior in groups 1 and 3 compared to controls.
Central nervous system biometry is altered in fetuses with CHD. PV is enlarged in CHD fetuses especially with decreased oxygen levels in the aortic arch.
比较在胎儿第二和第三孕期常规超声扫描中评估有先天性心脏病（CHD）和无先天性心脏病胎儿的脑结构。
这是一项回顾性的横断面单中心研究。我们测量了头围（HC）、小脑横径（TCD）和小脑延髓池（CM）、透明隔腔（CSP）和后颅窝（PV）的大小，在 20 至 41 孕周进行。我们将 160 例 CHD 胎儿（病例组）与 160 例正常妊娠胎儿（对照组）进行比较。每个患者都与一名对照者相匹配，考虑到进行超声检查的胎龄。我们将 CHD 组分为 3 个亚组：主动脉弓逆行血流（第 1 组）、主动脉弓前向血流右心异常（第 2 组）和其他主动脉弓前向血流 CHD（第 3 组）。
与对照组相比，第 1 组和第 3 组胎儿的 PV 平均宽度更大（P<0.001，P=0.022；分别）。我们发现，第 1 组和第 3 组的 5 分钟 APGAR 评分（P<0.001，P<0.001；分别）和分娩时的胎龄（P=0.006，P=0.001；分别）均低于对照组。
CHD 胎儿的中枢神经系统生物测量值发生改变。PV 在 CHD 胎儿中增大，尤其是在主动脉弓氧水平降低时。
