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胎儿动脉导管过早收缩。

Fetal Ductus Arteriosus Premature Constriction.

机构信息

Department of Obstetrics, Women's Hospital, Medical School of Zhejiang University & Key Lab of Women's Reproductive Health Zhejiang.

出版信息

Int Heart J. 2022 Jul 30;63(4):722-728. doi: 10.1536/ihj.21-723. Epub 2022 Jul 14.

Abstract

This study aimed to investigate the connections between the echocardiography indices of fetal ductus arteriosus premature constriction and newborn prognosis by analyzing 22 cases of spontaneous fetal ductus arteriosus premature constriction.An ultrasonic instrument was used to observe prenatal fetal heart state, combine clinical examination data and echocardiographic results after delivery, summarize the ultrasound manifestations and imaging characteristics, and analyze the prognosis of the fetus.In all cases, fetal ductus arteriosus premature constriction occurred in the third trimester of pregnancy (34 + 1 to 41 weeks), and no abnormality in extracardiac organs were observed. Seven neonates required respiratory support due to the accompanying severe tricuspid regurgitation. The remaining 15 neonates did not receive respiratory support, including 4 with severe tricuspid regurgitation, 5 with moderate regurgitation, and 6 with mild regurgitation. Significant differences were observed in the fetal right atrium size and tricuspid regurgitation severity between the neonatal respiratory support group and non-respiratory support group. Furthermore, there were statistical differences in the ductus arteriosus inner diameter and pulsation index between the two groups.The severity of fetal ductus arteriosus premature contraction accompanied by tricuspid regurgitation and right atrium enlargement can predict the immediate prognosis of the newborn and provide guidance for the clinical judgment of the timing of pregnancy termination.

摘要

本研究通过分析 22 例自发性胎儿动脉导管提前收缩病例,旨在探讨胎儿动脉导管提前收缩的超声心动图指标与新生儿预后的关系。采用超声仪器观察产前胎儿心脏状态,结合分娩后临床检查资料和超声心动图结果,总结超声表现及影像学特征,并分析胎儿预后。所有病例均发生在妊娠晚期(34+1 至 41 周),均未发现心脏外器官异常。7 例新生儿因伴有严重三尖瓣反流而需要呼吸支持。其余 15 例新生儿无需呼吸支持,其中 4 例伴严重三尖瓣反流,5 例中度反流,6 例轻度反流。新生儿呼吸支持组与非呼吸支持组在胎儿右心房大小和三尖瓣反流严重程度方面存在显著差异。此外,两组之间的动脉导管内径和搏动指数也存在统计学差异。伴有三尖瓣反流和右心房增大的胎儿动脉导管提前收缩的严重程度可以预测新生儿的即时预后,并为临床判断终止妊娠的时机提供指导。

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