体外受精-胚胎移植胎儿先天性心脏病的超声表现及分类特征  

Manifestation and classification of fetal congenital heart disease of in vitro fertilization-embryo transfer in echocardiography

作　　者：耿丹明[1] 王鸿[1] 吴琳琅[1] 王玉新[1] 

机构地区：[1]南京军区福州总医院超声诊断科,350025

出　　处：《中华医学超声杂志（电子版）》2014年第4期43-47,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨体外受精-胚胎移植（IVF-ET）妊娠的心脏病胎儿超声心动图特征及分类情况的特殊性。方法对2011年1月至2013年6月孕18-24周在南京军区福州总医院行胎儿超声心动图检查的IVF-ET妊娠孕妇1129例，分析IVF-ET妊娠胎儿先天性心脏病超声表现及分类特征，并对部分检出胎儿心脏病的孕妇选择性进行羊水穿刺术，追踪所有入选孕妇的妊娠过程及胎儿临床结局。结果1129例接受IVF-ET的孕妇中单胎妊娠953例、双胎妊娠176例，共检测胎儿1305个，其中超声心动图诊断胎儿心脏畸形15例（1.1%，15/1305），临床确诊15例。IVF-ET心脏畸形胎儿超声心动图表现：（1）法洛四联症5例，超声心动图示胎儿主动脉增宽伴骑跨，室间隔缺损，肺动脉狭窄，右心室肥厚。（2）左心发育不良综合征1例，超声心动图示胎儿左心明显缩小，二尖瓣闭锁，右心扩大，肺动脉扩张。（3）完全型房室间隔缺损1例，超声心动图示胎儿心内膜正常十字交叉结构消失，房室共瓣。（4）大动脉共干Ⅰ型1例，超声心动图示胎儿心底部仅见1条大血管，短小的肺动脉主干自大动脉发出，并见室间隔缺损。（5）主动脉狭窄及缩窄各1例，超声心动图示1例胎儿主动脉瓣增厚，升主动脉增宽；1例胎儿主动脉峡部狭窄伴狭窄后扩张。（6）肺动脉狭窄2例，超声心动图示胎儿肺动脉瓣狭窄伴狭窄后肺动脉扩张。（7）室间隔缺损3例，超声心动图示胎儿室间隔连续中断，断端边缘回声增强。超声漏诊胎儿室间隔小缺损1例，为出生后超声心动图检查发现。结论 IVF-ET妊娠胎儿较自然妊娠胎儿先天性心脏病的发生率高，IVF-ET妊娠胎儿与自然妊娠胎儿先天性心脏病的超声心动图表现相同。其中以法洛四联症和室间隔缺损最多见。对IVF-ET妊娠胎儿行超声心动图检查能全面系统评价IVF-ET妊娠胎儿心脏异常的情Objective To evaluate the manifestation and classiifcation of fetal congenital heart disease of in vitro fertilization-embryo transfer （IVF-ET） in echocardiography. Methods One thousand one hundred and twenty-nine IVF-ET pregnant women undergone echocardiography between 18-24 weeks gestation from Jan 2011 to Jun 2013 were studied. In Fuzhou General Hospital of Nanjing Command, we analyzed manifestation and classiifcation of fetal congenital heart disease in echocardiography, performed amniocentesis selectively and followed entire pregnancy and clinical outcome of all pregnant women selected. Results There were 953 cases of single pregnancy and 176 cases of gemellary pregnancy, and 1 305 fetus were obtained. Fifteen cases were diagnosed congenital heart diseases by echocardiography （1.1%, 15/1 305） and 15 cases were diagnosed congenital heart disease by clinic. Manifestations in echocardiography of fetal congenital heart disease were as followed：（1） Five cases of tetralogy of Fallot showed：aorta widened with ride across, ventricular septal defect, pulmonary stenosis and right ventricular hypertrophy. （2） One case of hypoplastic left heart syndrome showed：signiifcant reduction of left heart, mitral valve atresia, right heart enlargement and dilation of pulmonary artery. （3） One case of complele atrioventricular septal defect showed：disappeared of endocardial cross structure, common atrioventricular valve. （4） One case of truncus arteriosus-I showed：only one great vessel in heart bottom, short and pulmonary artery trunk from the aorta smallish main pulmonary artery started from main artery and ventricular septal defect. （5） Each one case of aortic stenosis and aortic coarctation showed：one with thicken aortic valve and widened ascending aorta, the other with aortic isthmus stenosis followed by dilatation. （6） Two cases of pulmonary artery stenosis showed：pulmonary valve stenosis followed by diatation. （7） Three cases of ventricular septal defect showed：ventricular

关 键 词：超声检查 产前 超声心动描记术 受精 体外 心脏病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]