Macedo A J, Ferreira M, Borges A, Sampaio A, Ferraz F, Sampayo F
Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Lisboa.
Acta Med Port. 1993 Nov;6 Suppl 1:I9-13.
During the last three years (July 89 to July 92), 875 fetal echocardiographic studies were performed, at a mean gestational age of 26 +/- 6.5 weeks (12 to 40 weeks), with the following main referral indications: family history of congenital heart disease 23%; advanced maternal age 13%; fetal arrhythmia 10%; amniotic fluid abnormalities 8%; fetal malformations 7%; diabetes 6%; four chamber view changes 4%. There were 15 twin pregnancies, two of them thoracopagus. The referral patterns with higher percentage of cardiac pathology were: abnormal four chamber view 56%; fetal chromosomal anomalies 50%; omphalocele 33%; twin pregnancy 33%; IUGR 29%; arrhythmias 20%. The referral patterns with lower percentage of cardiac pathology were: congenital heart disease in the family 0.2%; maternal risk 2%; amniotic fluid volume alterations 2%. The diagnosis of congenital heart disease was made in 37 fetus (4.2%), with the following most frequent: 9 cases with the atrioventricular septal defect, 5 cases with ventricular septal defect, 5 cases with hypoplastic left heart syndrome and 5 cases with tricuspid valve abnormalities. From a total of 78 referred fetal arrhythmias, 25 were confirmed, 20 being ectopic beats without structural heart disease, 3 with tachycardia, and 2 with bradycardia. One newborn with tachycardia and Ebstein's disease died, and the fetus with AV block and left atrial isomerism died in utero. The treatment and follow up of the remaining cases with heart disease are described. The whole mortality in the cases with heart pathology was 65%.(ABSTRACT TRUNCATED AT 250 WORDS)
在过去三年(1989年7月至1992年7月)期间,共进行了875例胎儿超声心动图检查,平均孕周为26±6.5周(12至40周),主要转诊指征如下:先天性心脏病家族史23%;母亲高龄13%;胎儿心律失常10%;羊水异常8%;胎儿畸形7%;糖尿病6%;四腔心切面改变4%。有15例双胎妊娠,其中2例为胸腹联体双胎。心脏病理比例较高的转诊模式为:四腔心切面异常56%;胎儿染色体异常50%;脐膨出33%;双胎妊娠33%;胎儿生长受限29%;心律失常20%。心脏病理比例较低的转诊模式为:家族性先天性心脏病0.2%;母亲风险因素2%;羊水量改变2%。37例胎儿(4.2%)被诊断为先天性心脏病,最常见的类型如下:9例房室间隔缺损,5例室间隔缺损,5例左心发育不良综合征,5例三尖瓣异常。在总共78例转诊的胎儿心律失常中,25例得到确诊,20例为无结构性心脏病的异位搏动,3例为心动过速,2例为心动过缓。1例患有心动过速和埃布斯坦畸形的新生儿死亡,1例患有房室传导阻滞和左房异构的胎儿死于宫内。描述了其余心脏病病例的治疗和随访情况。心脏病病例的总死亡率为65%。(摘要截断于250字)