母胎医学多学科诊疗模式下胎儿心脏超声异常孕妇妊娠结局及产后结果分析  

Analysis of pregnancy outcome and postpartum condition of patients with fetal echocardiography abnormalities under maternal-fetal medicine multidisciplinary diagnosis and treatment mode

作　　者：邓涵予 阮燕萍[1] 谷孝艳[1] 韩建成[1] 张烨[1] 孙琳[1] 赵映[1] 刘晓伟[1] 陈卓 孙海瑞 何怡华[1] DENG Han-yu;RUAN Yan-ping;GU Xiao-yan;HAN Jian-cheng;ZHANG Ye;SUN Lin;ZHAO Ying;LIU Xiao-wei;CHEN Zhuo;SUN Hai-rui;HE Yi-hua(Echocardiography Medical Center,Beijing Anzhen Hospital,Capital Medical University&Maternal-Fetal Medicine Center in Fetal Heart Disease,Beijing Anzhen Hospital,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心脏超声医学中心(胎儿心脏病母胎医学中心),北京100029

出　　处：《中国实用妇科与产科杂志》2024年第4期448-452,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金委员会-广东省人民政府自然科学联合基金重点支持项目(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);北京市安贞医院自然科技发展基金(2022-H0201)。

摘　　要：目的 通过对母胎医学多学科诊疗模式下胎儿心脏超声异常孕妇妊娠结局和产后情况进行分析,旨在为母胎医学多学科诊疗模式针对胎儿心脏病单病种的获益人群和各级预防获益情况提供数据研究基础。方法回顾分析2014—2021年在北京安贞医院进行母胎医学多学科会诊的1342例胎儿心脏超声异常孕妇,分析胎儿的出生结局和孕妇再次妊娠结局。结果 (1)494例合并母体自身免疫性疾病孕妇经母胎医学多学科会诊后,胎儿出生466例,其中手术2例,均未出现并发症和后遗症。这部分孕妇再次妊娠188例,均正常。(2)488例单纯胎儿先天性心脏病孕妇经母胎医学多学科会诊后,胎儿出生185例,其中手术112例,110例未出现术后并发症和后遗症。这部分孕妇再次妊娠208例,下一胎正常205例。(3)360例合并遗传综合征的胎儿心脏异常孕妇经母胎医学多学科会诊后全部引产,下一胎正常1例。结论 母胎医学多学科诊疗模式实现了产前多维度诊断。推进了对合并母体自身免疫性疾病、单纯胎儿先天性心脏病和合并遗传综合征的胎儿心脏异常这三类孕妇的一、二、三级预防,降低了畸形胚胎的出生及新生儿死亡率,提高了患儿生存质量。ObjectiveTo analyze the pregnancy outcomes and postpartum conditions of pregnant women with abnormalfetal cardiac ultrasound under the multidisciplinary diagnosis and treatment mode of maternal-fetal medicine,in order toprovide data research basis for the benefit groups and prevention benefits at all levels of fetal heart disease in thematernal-fetal medicine mode.MethodsA retrospective analysis was made involving 1342 pregnant women whoreceived multidisciplinary consultation of maternal-fetal medicine in Beijing Anzhen Hospital from 2014 to 2021,andthe outcomes of fetal birth and second pregnancy were analyzed.Results(1)Totally 494 cases of fetuses with maternalautoimmune diseases were born after consultation of maternal-fetal medicine,with 466 births.There were nocomplications or sequelae in 2 cases of postnatal operation.Among these women,188 pregnancies occurred again,all ofwhich were normal.(2)There were 185 cases of birth in 488 cases of simple fetal heart malformation after maternal-fetal medical consultation,of which 112 cases were operated and 110 cases did not have postoperative complications orsequelae.Among these women,208 had a second pregnancy,and 205 had a normal birth.(3)All of the 360 cases of cardiac abnormalities with genetic syndrome wereinduced after maternal-fetal medical consultation,and 1case of the next pregnancy was normal.Conclusions Multi-disciplinary diagnosis and treatment mode ofmaternal-fetal medicine can realize multi-dimensionalprenatal diagnosis,and it promotes the primary,secondary and tertiary prevention of these three groups ofpregnant women(complicated with maternal autoimmune diseases,simple fetal heart malformations and genetic syndromes),reduces the birth of deformed embryos and neonatalmortality,and improves the quality of life of children.

关 键 词：母胎医学多学科诊疗模式 胎儿心脏超声异常 获益人群 预防获益 

分 类 号：R714.5[医药卫生—妇产科学]