Sandor G G, Farquarson D, Wittmann B, Chow T C, Lau A E
Obstet Gynecol. 1986 Mar;67(3):358-64.
The results of 140 fetal cardiac scans in 124 high-risk obstetric patients (16 to 40 weeks' gestation) are presented. Sixty patients were scanned for high genetic or environmental risk (group 1); 31 because of fetal abnormality detected on routine ultrasound scanning (group 2) and 37 because of arrhythmias (group 3). Three patients were in two groups. The standard echocardiography views, ie, long-axis, great vessel short axis, four chamber, and aortic arch were obtained in 72, 95, 96, and 55%, respectively. All scans in group 1 were diagnosed as normal. In group 2, complex cardiac abnormalities were detected, the presence of fetal cardiac failure and its cause were clarified, and serious cardiac malformations were excluded. Arrhythmias in group 3 were diagnosed correctly and fetal hemodynamics assessed. A small number of lesions were not detected or diagnosed. The factors interfering with detection of lesions were abnormalities of the intrathoracic or abdominal cavity, inadequate amniotic fluid, and size of lesions. Major cardiac structures or abnormalities could be identified, and abnormal hemodynamics caused by arrhythmias and structural lesions assessed. Unnecessary intervention was prevented in five cases and conversely the need for acute intervention was indicated in seven cases. Fetal echocardiography remains a specialized investigation that has an important role in the management of some high-risk pregnancies.
本文呈现了124例高危产科患者（妊娠16至40周）的140次胎儿心脏扫描结果。60例患者因高遗传或环境风险接受扫描（第1组）；31例因常规超声扫描发现胎儿异常接受扫描（第2组），37例因心律失常接受扫描（第3组）。3例患者分属两组。标准超声心动图视图，即长轴、大血管短轴、四腔心和主动脉弓视图的获取率分别为72%、95%、96%和55%。第1组所有扫描均诊断为正常。在第2组中，检测到复杂心脏异常，明确了胎儿心力衰竭的存在及其病因，并排除了严重心脏畸形。第3组的心律失常得到正确诊断，并评估了胎儿血流动力学。少数病变未被检测或诊断出来。干扰病变检测的因素包括胸腔或腹腔异常、羊水过少和病变大小。主要心脏结构或异常能够被识别，心律失常和结构病变导致的异常血流动力学也能得到评估。5例避免了不必要的干预，相反，7例表明需要进行紧急干预。胎儿超声心动图仍是一项专门检查，在一些高危妊娠的管理中发挥着重要作用。
