单脐动脉胎儿心脏畸形超声筛查的意义  

Significance of echocardiographic screening of cardiac defects for fetuses with single umbilical artery

作　　者：辛甜甜[1] 席丽丽[2] 赵丽娇[2] 祝菁[3] 谢静[1] 孙锟[1] 陈笋[1] 

机构地区：[1]上海交通大学医学院附属新华医院小儿心血管科,上海200092 [2]上海交通大学医学院附属新华医院超声科,上海200092 [3]上海交通大学医学院附属新华医院妇产科,上海200092

出　　处：《上海交通大学学报（医学版）》2014年第5期666-670,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海交通大学"医工(理)交叉研究基金"项目(YG2011MS08);国家重点基础研究发展计划("973"计划)(2010CB529501);上海市科委医学重大项目(10DZ1951203)~~

摘　　要：目的探讨单脐动脉(SUA)与心脏畸形的关系及对SUA胎儿常规进行超声心动描记术检查的必要性。方法 2009年9月—2012年9月因存在胎儿先天性心脏病高危因素接受胎儿超声心动描记术检查的孕妇666名,采用节段性分析法扫查心脏切面,对胎儿的心脏位置、主要结构及连接进行分析和评价,根据胎儿是否存在SUA分为单纯SUA组(A组,n=63)、SUA合并其他先天性心脏病高危因素组(B组,n=15)和非SUA但存在其他先天性心脏病高危因素组(C组,n=588),所有胎儿出生后1个月内接受超声心动描记术检查,对三组胎儿心脏畸形的发生情况进行分析和比较。结果 A、B、C组心脏畸形的发生率分别为9.5%(6/63)、40.0%(6/15)和3.9%(23/588)。统计学分析结果显示:B组心脏畸形发生率显著高于其他两组,A组心脏畸形发生率显著高于C组,差异均有统计学意义(P<0.05)。结论 SUA胎儿先天性心脏病的发生率较高,因此对SUA胎儿尤其是合并先天性心脏病高危因素者,有必要常规进行超声心动描记术检查。Objective To explore the relationship between the single umbilical artery （SUA） and cardiac defects and the necessity of routinely conducting fetal echocardiography for fetuses With SUA. Methods The routine fetal echocardiography was performed for 666 singleton pregnancies with high risk of fetal congenital heart disease （CHD） from September, 2009 to September, 2012. The sequential segmental analysis method was used to scan cardiac planes and to analyze and evaluate the position, major structures, and connections of the fetal heart. All cases were divided into the isolated SUA group （ group A, n =63）, SUA with other high risk factors of CHD group （group B, n =15）, and non-SUA with other high risk factors of CHD group （group C, n =588）. The echocardiography was performed for all fetuses after they were born for one month. The cardiac defects of three groups were analyzed and compared. Results The incidences of cardiac defects of three groups were 9.50/0 （6/63）, 40.0% （6/15）, and 3.90/0 （23/588）, respectively. The results of statistical analysis showed that the incidence of cardiac defects of group B was significantly higher than that of other two groups and the incidence of cardiac defects of group A was significantly higher than that of group C. The differences were statistically significant （P 〈 0. 05）. Conclusion The incidence of CHD of fetuses with SUA is extremely high. The routine fetal echocardiography is necessary for fetuses with SUA, especially for those associated with other high risk factors of CHD.

关 键 词：单脐动脉 心脏畸形 胎儿心脏 超声心动描记术 

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]