辅助生殖技术胎儿产前诊断心血管异常的疾病谱分析  

Analysis of the spectrum of cardiovascular anomalies diagnosed prenatally in fetuses with assisted reproductive technology

作　　者：满婷婷[1] 阮燕萍[1] 刘晓伟[1] 张烨[1] 孙琳[1] 谷孝艳[1] 赵映[1] 何怡华[1] MAN Tingting;RUAN Yanping;LIU Xiaowei;ZHANG Ye;SUN Lin;GU Xiaoyan;ZHAO Ying;HE Yihua(Department of Echocardiography Medical Center,Beijing Anzhen Hospital,Capital Medical University,Maternal-Fetal Medicine center in Fetal Heart Disease,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所、心脏超声医学中心、北京安贞医院胎儿心脏病母胎医学中心,100029

出　　处：《心肺血管病杂志》2023年第3期257-261,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(U21A20523);国家自然科学基金面上项目(82170301);心血管疾病精准医学北京实验室(PXM2018_014226_000013);胎儿心脏病母胎医学北京重点实验室(BZ0308)。

摘　　要：目的:分析应用辅助生殖技术(ART)胎儿的超声心动图结果,分析其合并心血管异常(CA)的疾病谱,为ART胎儿合并CA及其围产期管理提供参考。方法:回顾性分析于我院产前超声心动图诊断CA的ART胎儿243例。总结并分析其合并CA类型以及预后分级情况。结果:243例ART胎儿中,合并CA以心室-动脉连接异常为主(67/243,27.6%),其次为心室/室间隔异常(47/243,19.3%)和动脉系统(含动脉导管)异常(45/243,18.5%)。合并CA最常见为单纯室间隔缺损(33/243,13.6%),其次为永存左上腔静脉(28/243,11.5%)、右位主动弓(26/243,10.7%)。胎儿CA的预后分级中,Ⅰ、Ⅱ级的占比为63.0%(153/243),Ⅲ级为26.3%(64/243),Ⅳ级为10.7%(26/243)。结论:ART胎儿可合并各种CA,以室间隔缺损较多见。建议对ART胎儿常规行产前超声心动图检查,评估胎儿心脏结构及功能情况,为ART家庭的咨询提供更多指导。Objective:To analyze the echocardiographic findings of fetuses with assisted reproductive technology(ART),and analyze the spectrum of their combined cardiovascular abnormalities(CA)to provide a reference for the combined CA in ART fetuses and their perinatal management.Methods:Retrospective analysis of 243 ART fetuses with CA diagnosed by prenatal echocardiography in our hospital.The types of combined CA and their prognostic grading were summarized and analyzed.Results:Among 243 cases of fetuses with ART,the combined CA was predominantly associated with abnormalities of ventricular-arterial connection(67/243,27.6%),followed by abnormalities of ventricular/ventricular septal(47/243,19.3%)and arterial system (including the ductus arteriosus)(45/243, 18.5%). The most common combined CA was ventricular septal defect (33/243, 13.6%), followed by permanent left superior vena cava (28/243, 11.5%) and right aortic arch (26/243, 10.7%). The prognostic grading of CA was 63.0% for grades I and II (153/243), 26.3% for grade III (64/243), and 10.7% for grade IV (26/243). Conclusions: ART fetuses can be combined with various CA, with ventricular septal defect being more common. It is recommended that prenatal echocardiography should be routinely performed in ART fetuses to assess the fetal cardiac structure and function, and to provide more guidance for consultation of ART families.

关 键 词：辅助生殖技术 超声心动描记术 胎儿 心血管畸形 产前诊断 

分 类 号：R54[医药卫生—心血管疾病]