Comstock C H, Smith R, Lee W, Kirk J S
Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
Obstet Gynecol. 1998 Apr;91(4):495-9. doi: 10.1016/s0029-7844(98)00018-0.
To ascertain the clinical significance of right fetal cardiac axis.
Fetal cardiac axis was assessed prospectively in ultrasound examinations of 16,562 fetuses over a 6-year period.
Twenty-two fetuses had a right cardiac axis. When classified by ventricular and atrial configuration, six fetuses had mirror-image hearts with situs inversus, 12 had rotation of the heart axis alone, and four had inversion of the ventricles. Fourteen of the 22 had underlying structural cardiac defects, most of which were atrioventricular septal defects, double outlet right ventricles, or common atria. The chromosomes and/or phenotypes of all 22 were normal. All four fetuses with polysplenia and asplenia died. Major extracardiac defects were few (two) but lethal.
Right cardiac axis in the fetus is associated with a high incidence of structural cardiac defects. In the absence of severe extracardiac defects, polysplenia, or asplenia, neonatal outcome was good.
确定胎儿右心轴的临床意义。
在6年时间里，对16562例胎儿进行超声检查，前瞻性评估胎儿心轴。
22例胎儿有心轴右偏。按心室和心房结构分类，6例胎儿为镜像心伴内脏反位，12例仅有心轴旋转，4例有心室倒置。22例中有14例存在潜在的心脏结构缺陷，其中大多数为房室间隔缺损、右心室双出口或共同心房。22例胎儿的染色体和/或表型均正常。4例患有多脾和无脾的胎儿均死亡。主要的心外缺陷较少（2例）但致命。
胎儿心轴右偏与心脏结构缺陷的高发生率相关。在没有严重的心外缺陷、多脾或无脾的情况下，新生儿预后良好。
