Achiron R, Weissman A, Rotstein Z, Lipitz S, Mashiach S, Hegesh J
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
J Ultrasound Med. 1994 Oct;13(10):783-9. doi: 10.7863/jum.1994.13.10.783.
The object of our investigation was to evaluate the potential of transvaginal echocardiography for a complete anatomic study of the fetal heart, and for detection of congenital heart diseases in low-risk pregnant patients between 13 and 15 weeks' gestation. High-frequency (6.5 MHz and 7.5 MHz) transvaginal probes were employed for fetal echocardiographic assessment. Six hundred and sixty patients considered at low risk for congenital heart disease underwent in utero ultrasonographic studies, neonatal records, postnatal imaging studies, and pathologic examination. The four-chamber view was obtained in 100% of the fetuses, while the extended fetal heart examination was completed in 98%. Six fetuses with cardiac defects were diagnosed during the study: three had major heart defects (aortic atresia, tetralogy of Fallot, and persistent truncus arteriosus), all detected at the early transvaginal scan; three cardiac anomalies escaped our early diagnosis; two fetuses had a minor ventricular septal defect diagnosed only postnatally; and one had multiple cardiac rhabdomyoma diagnosed in the third trimester. Our results demonstrate that between 13 and 15 weeks' gestation transvaginal echocardiographic assessment of the fetal heart in the low-risk population is feasible. Moreover, some severe anomalies may be detected at such an early gestational age.
我们研究的目的是评估经阴道超声心动图对胎儿心脏进行完整解剖学研究以及检测妊娠13至15周低风险孕妇先天性心脏病的潜力。使用高频（6.5兆赫和7.5兆赫）经阴道探头进行胎儿超声心动图评估。660名被认为先天性心脏病低风险的患者接受了宫内超声检查、新生儿记录、产后影像学检查和病理检查。100%的胎儿获得了四腔心切面图像，98%完成了扩展胎儿心脏检查。研究期间诊断出6例有心脏缺陷的胎儿：3例有严重心脏缺陷（主动脉闭锁、法洛四联症和永存动脉干），均在早期经阴道扫描时检测到；3例心脏异常未被早期诊断；2例胎儿有小室间隔缺损，仅在出生后诊断；1例在孕晚期被诊断为多发性心脏横纹肌瘤。我们的结果表明，在妊娠13至15周对低风险人群进行经阴道超声心动图胎儿心脏评估是可行的。此外，在如此早的孕周可以检测到一些严重异常。
