von Bernuth G
Z Geburtshilfe Perinatol. 1981 Aug;185(4):200-6.
Knowledge of the changes during transition from fetal to neonatal circulation is useful for the understanding of physiologic and pathologic variations in the neonatal cardiovascular system. Cyanosis as well as clinical symptoms of congestive heart failure in the neonate are unspecific and may represent cardiac and noncardiac disease (primary pulmonary disease, septicemia, intracranial haemorrhage or meningitis, polyglobulism). Besides detailed analysis of clinical symptoms, the examination of arterial bloodgases when breathing from room air and 100% oxygen, the electrocardiogram, the chest-roentgenogram, and the echocardiogram are of diagnostic value. Specific cardiovascular problems during the neonatal period are the patent ductus arteriosus in the premature infant and the so-called persistent fetal circulation. Among the many congenital cardiac defects potentially causing problems in the neonate the most important are complete transposition of the great arteries, coarctation of the aorta, hypoplastic left heart syndrome, and severe tetralogy of Fallot or pulmonary atresia with ventricular septal defect. With good cooperation between obstetrician, neonatologist and paediatric cardiologist, most neonates with cardiologic problems can nowadays be timely diagnosed and successfully treated.
了解从胎儿循环过渡到新生儿循环期间的变化，有助于理解新生儿心血管系统的生理和病理变异。新生儿的青紫以及充血性心力衰竭的临床症状并无特异性，可能代表心脏和非心脏疾病（原发性肺部疾病、败血症、颅内出血或脑膜炎、红细胞增多症）。除了详细分析临床症状外，在呼吸室内空气和100%氧气时检查动脉血气、心电图、胸部X线片和超声心动图具有诊断价值。新生儿期特有的心血管问题是早产儿动脉导管未闭和所谓的持续胎儿循环。在众多可能给新生儿带来问题的先天性心脏缺陷中，最重要的是大动脉完全转位、主动脉缩窄、左心发育不全综合征以及严重法洛四联症或伴有室间隔缺损的肺动脉闭锁。通过产科医生、新生儿科医生和儿科心脏病专家之间的良好合作，如今大多数有心脏问题的新生儿都能得到及时诊断和成功治疗。
