Objective To investigate the clinical value of prenatal ultrasound in diagnosis of abnormalities in fetal circulation channels (FCC).Methods A retrospective study was conducted among 131 cases with abnormal FCC [including venous catheter (DV), foramen ovale (FO), patent ductus arteriosus (DA)] detected by prenatal ultrasound examination from January 2016 to June 2017 in Beijing Obstetrics and Gynecology Hospital. All cases have been followed up to the outcome of pregnancy.Results Among 131 patients with abnormal FCC, 46 cases had abnormal DV, 53 cases of FO abnormalities, 32 patients with abnormal DA. For cases with abnormal DV, 6 of them were DV agenesis, 2 cases were with narrow diameter and 38 cases were with abnormal blood flow; other complicated abnormality included NT thickening, fetal neck cystic hygroma and fetal hydrops. For cases of FO abnormalities, 45 of them were with abnormal internal diameter of FO, 6 cases were with abnormal oval valves, 2 cases were with abnormal blood flow, other complicated abnormality included abnormal left ventricular vein, hypoplastic right heart and endocardial cushion defect. For cases with abnormal DA, 5 of them were DA agenesis, 12 cases were with abnormal structure, 3 cases were with abnormal contorts, 12 cases were with abnormal blood flow; other complicated abnormality included transposition of great arteries, pulmonary atresia, right aortic arch with abnormal. The overall fetal survival rate was 49.6%, and the abnormal survival rates of DV, FO and DA were 13.0%, 92.5%, 56.3%, respectively.Conclusion It is useful for prenatal ultrasound monitoring of FCC in clinical practice. To observe the diameter, shape, flow direction and spectrum of fetal FCC, valuable references to clinical consultation and prognosis evaluation could be provided.
Key words
Prenatal ultrasound /
Fetal circulation channels /
Ductus venous /
Foramen ovale /
Ductus arteriosus
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References
1 田源,吴青青,王莉.ISUGO早孕期胎儿超声扫查应用指南解读.中华医学超声杂志(电子版) ,2014,11:15-17.
2 吴青青,杨文娟.解读胎儿孕中期常规超声筛查应用指南[国际妇产科超声学会(ISUGO)] 中华医学超声杂志(电子版) ,2011,8:17-21.
3 孙夫丽,吴青青,王莉.ISUOG实用指南(更新版):胎儿心脏超声筛查指南解读,2014,11:10-14.
4 Kiserud T,Rasmussen S,Skulstad SM.Blood flow and degree of shunting through the ductus venosus in the human fetus.Am J Obstet Gynecol,2000,182:147-153.
5 Kiserud T,Acharrya G.The Fetal Circulation.Prenat Diagn,2004,24:1049-1059.
6 Gerards FA,Twisk JW,Vugt JM.Doppler velocimetry of the ductus arteriosus in normol fetuses and fetuses suspected for pulmonary hypoplasia.Fetal Diagn ther,2009,26:143-147.
7 姚远,李胜利,陈秀兰,等.静脉导管缺失的产前超声诊断.中国超声医学杂志,2011,27:458-460.
8 Wagner P,Sonek J,Klein J,et al.First-trimester ultrasound screening for trisomy 21 based on maternal age,fetal nuchal translucency,and different methods of ductus venosus assessment.Prenat Diagn,2017,37:680-685.
9 刘冬梅,杨敏,顾晓宁,等.静脉导管频谱在筛查胎儿先天性心脏畸形中的价值.哈尔滨医科大学学报,2016,50:342-345.
10 张丽娜,吴青青 姚苓,等.胎儿期卵圆孔、卵圆瓣异常的超声表现及预后分析.中国生育健康杂志.2016,27:417-419.
11 闫合理,闫珊乐,徐兴森,等.产前超声诊断胎儿卵圆孔血流受限或提前闭合的临床价值.临床超声医学杂志,2015,17:767-769.
12 Donofrio MT,Bremer YA,Moskowitz WB.Diagnosis and management of restricted or closed foramen ovale in fetuses with congenital heart disease.Am J Cardiol,2004,94:1348-1351.
13 王红英,戴常平,黄岚,等.胎儿动脉导管异常在新天新心脏病产前诊断中的价值.中华围产医学杂志,2013,16:689-692.
14 张烨,何怡华,孙琳,等.胎儿动脉导管血流频谱与优势梗阻性疾病肺动脉发育相关分析.中国超声医学杂志,2015,31:355-357.
15 Quartermain MD,Glatz AC,Goldberg DJ,et al.Pulmonary outflow tract obstruction in fetuses with complex congenital heart disease:predicting the need for neonatal intervention.Ultrasound Obstet Gynecol,2013,41:47-53.
16 张家敏,马永红,沈艳,等.超声心动图对胎儿动脉导管狭窄及早闭的诊断.中国临床医学影像杂志,2017,28:204-207.
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