Hata Toshiyuki, Koyanagi Aya, Takayoshi Riko, Miyagi Yasunari, Miyake Takahito
Department of Obstetrics and Gynecology, Miyake Clinic, Okayama, Japan.
Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan.
Case Rep Perinat Med. 2024 Oct 9;13(1):20240025. doi: 10.1515/crpm-2024-0025. eCollection 2024 Jan.
To detect fetal hyaloid artery (FHA) blood flow using SlowHD in the first trimester.
During the 8-month period from February to September 2023, one-hundred and eighty-three trans-abdominal scans were performed for first-trimester screening in singleton pregnancies at 11-13 + 6 weeks of gestation. One-hundred and fifty-two cases were excluded from the study due to inappropriate fetal positions, excessive fetal movements, and excessive distances between the fetus and probe; thus, thirty-one fetuses (20.4 %) were examined, comprising 19 uni- and 12 bilateral orbits. One fetus with trisomy 21 was also evaluated at 12 weeks and 1 day. FHA was classified into two types based on the starting point angle (Straight, straightly diverged from ophthalmic artery; and Curved, crookedly diverged from ophthalmic artery) using SlowHD.
In 19 uni- and 12 bilateral orbits in 31 fetuses, FHA could be identified in all orbits. In one orbit at 13 weeks and 5 days, blood flow on the string FHA could be detected. The vasa hyaloidea propria was noted in 3 orbits, and the posterior vascular capsule was depicted in 7 orbits. The incidence of Straight-type FHA increased with advancing gestation (p<0.0001). In a fetus with Trisomy 21, Straight-type FHA was noted in the left orbit, whereas FHA could not be identified in the right orbit.
This is the first report on the detection of FHA in the first trimester of pregnancy. SlowHD may be a useful diagnostic modality to evaluate human vascular development, such as FHA .
在孕早期使用SlowHD检测胎儿玻璃体动脉(FHA)血流。
在2023年2月至9月的8个月期间,对11至13⁺⁶周单胎妊娠的孕早期进行了183次经腹扫描。由于胎儿位置不当、胎动过多以及胎儿与探头之间距离过大,152例被排除在研究之外;因此,对31例胎儿(20.4%)进行了检查,包括19个单眼眶和12个双眼眶。还对1例21三体胎儿在孕12周⁺¹天进行了评估。使用SlowHD根据起始点角度将FHA分为两种类型(直型,从眼动脉直接分出;弯型,从眼动脉弯曲分出)。
在31例胎儿的19个单眼眶和12个双眼眶中,所有眼眶均能识别出FHA。在孕13周⁺⁵天的1个眼眶中,可检测到条索状FHA上的血流。在3个眼眶中观察到固有玻璃体血管,在7个眼眶中描绘出后血管囊。直型FHA的发生率随孕周增加而升高(p<0.0001)。在1例21三体胎儿中,左眼眶可见直型FHA,而右眼眶未识别出FHA。
这是关于孕早期检测FHA的首次报告。SlowHD可能是评估人类血管发育(如FHA)的一种有用的诊断方法。