Pavlova M, Fouron J C, Drblik S P, van Doesburg N H, Bigras J L, Smallhorn J, Harder J, Robertson M
Department of Pediatrics, Sainte-Justine Hospital, University of Montreal, Quebec, Canada.
Am Heart J. 1998 Jun;135(6 Pt 1):1081-5. doi: 10.1016/s0002-8703(98)70076-6.
The echocardiographic criteria that have been used to evaluate severity of Ebstein's anomaly in utero are the same as those applied after birth.
The objective of this study was to establish prognostic criteria that take into account the peculiarities of the fetal hemodynamics.
The video recordings of eight fetuses with Ebstein's anomaly were retrospectively reviewed.
The following indexes had no prognostic significance either on fetal or neonatal outcome: the ratio of functional tricuspid opening over the diameter of the annulus, the degree of displacement of the tricuspid valve opening, and the degree of tricuspid regurgitation. The index of severity (based on the surfaces of right atrium + atrialized right ventricle) and the cardiothoracic ratio had a significant impact only on neonatal survival. The smallest fossa ovalis were found in two fetuses who had hydrops. Fetuses who reached term without problems had higher left ventricular outputs. A positive linear correlation was found between the z score of the left ventricular output and the size of the fossa ovalis (r = 0.81, p < 0.05).
The prognosis of Ebstein's anomaly during fetal life is not influenced by criteria described for postnatal life and may be related to factors that control the volume load of the left ventricle.
用于评估胎儿期埃布斯坦畸形严重程度的超声心动图标准与出生后使用的标准相同。
本研究的目的是建立考虑胎儿血流动力学特点的预后标准。
回顾性分析8例患有埃布斯坦畸形胎儿的视频记录。
以下指标对胎儿或新生儿结局均无预后意义：功能性三尖瓣开口与瓣环直径之比、三尖瓣开口移位程度和三尖瓣反流程度。严重程度指数（基于右心房+房化右心室的面积）和心胸比仅对新生儿生存有显著影响。在2例有水肿的胎儿中发现最小的卵圆孔。顺利足月的胎儿左心室输出量较高。左心室输出量的z评分与卵圆孔大小之间存在正线性相关（r = 0.81，p < 0.05）。
胎儿期埃布斯坦畸形的预后不受出生后描述的标准影响，可能与控制左心室容量负荷的因素有关。
