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目的本研究旨在探索静脉导管a波反向在胎儿先天性心脏病(CHD)及胎儿宫内生长受限(FGR)中的临床价值。方法选取不同孕周的57例孕妇,其中包括FGR胎儿32例,CHD胎儿25例。首先进行常规产前超声检查,然后行静脉导管检查,留取静脉导管彩色多普勒图像及其脉冲多普勒图像,观察是否存在a波反向。异常胎儿随访或产后超声复查,引产胎儿进行解剖对照分析。结果 1例室间隔完整的肺动脉闭锁及1例法洛氏四联症胎儿的静脉导管出现a波反向,1例静脉导管a波反向的FGR胎儿胎死宫内。结论胎儿静脉导管a波反向有助于前负荷增加为特点的胎儿CHD的检出,是预示FGR胎儿不良结局的危险信号。
Objective This study aimed to explore the clinical value of venous catheter a-wave inversion in fetal congenital heart disease (CHD) and fetal intrauterine growth restriction (FGR). Methods 57 pregnant women of different gestational age were selected, including 32 FGR fetuses and 25 fetuses with CHD. First of all routine prenatal ultrasound, and then intravenous catheter examination, venous catheter color Doppler imaging and pulsed Doppler images were taken to observe the existence of a-wave reverse. Abnormal fetal follow-up or post-natal ultrasound review, abortion fetus anatomical control analysis. Results One patient with intact ventricular septal pulmonary atresia and one patient with tetralogy of Fallot had an a-wave reverse and a venous catheter with a-wave reverse FGR fetus. Conclusions Fetal venous catheter a-wave reverse helps to detect fetal CHD, which is characterized by an increase of pre-load, which is a dangerous signal to predict the unfavorable outcome of FGR fetus.