Eapen R S, Rowland D G, Franklin W H
Department of Pediatrics, The Ohio State University, Children's Hospital, Columbus 43205, USA.
Am J Perinatol. 1998 Apr;15(4):237-42. doi: 10.1055/s-2007-993934.
We sought to determine the effect of prenatal diagnosis of congenital heart disease, specifically critical left heart obstructive (LHO) lesions, on postnatal morbidity and mortality. Several studies have found no significant improvement in mortality in infants with prenatally detected heart disease compared to infants diagnosed postnatally. Few reports have focused on the specific effects of prenatal diagnosis on the perinatal course. All newborns with LHO seen between July 1993 and July 1996 were identified and divided into two groups based on prenatal vs. postnatal diagnosis. Hospital records were reviewed for demographic and outcome variables. The outcome variables included degree of metabolic acidosis, hemodynamic instability, noncardiac organ dysfunction, delayed surgical intervention, and surgical mortality. Twenty-three fetuses were diagnosed with LHO lesions. Postnatally, 45 newborns presented with LHO anomalies. Prenatal diagnosis resulted in avoidance of hemodynamic compromise, reduced organ dysfunction, and reduced surgical delays. There was no significant difference in surgical mortality. Prenatal diagnosis significantly decreases postnatal morbidity in infants with LHO lesions. Although surgical results are similar, the reduced morbidity decreases surgical delays and potentially may impact on neurodevelopmental outcomes.
我们试图确定先天性心脏病（尤其是严重左心梗阻性[LHO]病变）的产前诊断对产后发病率和死亡率的影响。多项研究发现，与出生后诊断出心脏病的婴儿相比，产前检测出心脏病的婴儿在死亡率方面并无显著改善。很少有报告关注产前诊断对围产期过程的具体影响。对1993年7月至1996年7月期间所有患有LHO的新生儿进行了识别，并根据产前诊断与产后诊断将其分为两组。查阅医院记录以获取人口统计学和结局变量。结局变量包括代谢性酸中毒程度、血流动力学不稳定、非心脏器官功能障碍、手术干预延迟和手术死亡率。23例胎儿被诊断为LHO病变。出生后，45例新生儿出现LHO异常。产前诊断避免了血流动力学损害，减少了器官功能障碍，并减少了手术延迟。手术死亡率无显著差异。产前诊断显著降低了患有LHO病变婴儿的产后发病率。尽管手术结果相似，但发病率的降低减少了手术延迟，并可能对神经发育结局产生影响。
