胎儿卵圆孔早闭/血流受限4例并文献复习  

Four Cases Report of Fetal Foramen Ovale Closure-Restriction and Literature Review

作　　者：田玉翠[1] 刘妍[1] 王红梅[1] 赵友萍[1] TIAN Yucui;LIU Yan;WANG Hongmei;ZHAO Youping(Department of Perinatal Medicine,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院围产医学部产三科,北京100026

出　　处：《医学综述》2018年第4期820-826,共7页Medical Recapitulate

摘　　要：目的探讨产前超声提示胎儿卵圆孔早闭/血流受限(FO-C/R)患者最佳终止妊娠时机及方式。方法回顾性分析2014年1月1日至2017年1月1日在首都医科大学附属北京妇产医院分娩的4例患者的临床资料、超声表现及围生结局。结果 2例患者为孕中期发生胎儿FO-C/R,合并严重心内外畸形,均行致死性引产。其余2例患者分别于孕30周、34周发现胎儿卵圆孔血流受限(FO-R)(其中1例同时合并胎盘绒毛膜血管瘤、羊水过多、胎儿水肿、胎儿贫血、胎儿低蛋白血症),卵圆孔直径分别为2.6 mm、2.1 mm,动态随访至孕33周、35周胎儿卵圆孔直径分别为1.3 mm、2.1 mm伴三尖瓣反流时以剖宫产术终止妊娠;新生儿出生后3个月内心内结构及功能均恢复正常。结论孕中期发生的胎儿FO-C/R伴严重心内外畸形者,胎儿预后差。孕中晚期发现的未合并严重心内外畸形的胎儿FO-R患者可在胎儿超声心动图动态监测下继续妊娠,待胎儿肺成熟后终止妊娠;新生儿出生后心内结构和功能可恢复正常。Objective To investigate the optimal timing and mode of termination of pregnancy for patients with fetal foramen ovale closure-restriction(FO-C/R).Methods Four cases of fetal foramen ovale closure-restriction who delivered in Beijing Obstetrics and Gynecology Hospital between Jan.1st,2014 and Jan.1st,2017.Results Two cases of FO-C/R were complicated with severe malformation and underwent abortion during the second trimester.The other two cases were diagnosed with FO-R at 30 weeks and 34 weeks,the foramen ovale diameters were 2.6 mm and 2.1 mm,who underwent cesarean section at 33 weeks and 35 weeks respectively.The newborns′cardiac structure and function returned to normal 3 months after birth.Conclusion The prognosis is poor for patients with fetal foramen ovale closure-restriction complicated with severe malformation.Patients with fetal foramen ovale restriction without severe malformation can terminate pregnancy till fetal lung maturity with dynamically monitored fetal cardiac function.The fetal cardiac structure and function can return to normal after birth.

关 键 词：卵圆孔 胎儿 提前闭合 血流受限 超声心动图 

分 类 号：R714.51[医药卫生—妇产科学]