Abstract:【Objective】To explore the diagnostic value of echocardiography (ECG) in early closure and stenosis of fetal ductus arterio sus in late pregnancy.【Methods】The clinical and ECG data of 22 fetuses with premature closure and stenosis of ductus arteriosus diagnosed postpartum in our hospital from January 2017 to January 2019 were retrospectively analyzed. The prenatal and postpartum ECG imaging features were compared to evaluate the clinical value of ECG in the diagnosis of premature closure and stenosis of ductus arteriosus in fetus.【Results】The diagnostic accuracy of echocardiography for early closure and stenosis of fetal ductus arteriosus was 90.91% (20/22), and 2 cases were missed. Fetal echocardiographic features of premature closure and stenosis of ductus arteriosus during fetal period: right heart enlargement (mean diameter of right atrium 14.3 mm, mean diameter of right ventricle 14.7 mm), tricuspid valve with mild to moderate regurgitation, mean regurgitation velocity (163.75±13.42) cm/s, mean transvalvular pressure difference (61±11) mmHg; pulmonary valve mild to moderate regurgitation, mean regurgitation velocity (243.84 ±19.50) cm/s, the average transvalvular pressure difference was (29±9) mmHg. Pulmonary artery widening was observed in all 20 fetuses. The ratio of pulmonary artery diameter to aortic diameter was greater than 1.2. The mean diameter of the ductus arteriosus was (2.3±0.7) cm. Turbulent flow signals could be seen by ultrasound. The systolic flow velocity in the duct was more than 170.0 cm/s. 24 h postnatal echocardiographic characteristics: without detecting the arterial duct and its blood flow signals, the average diameter of right atrium was (13.7±0.6) cm, and the average diameter of right ventricle was (11.7±0.5) cm; the tricuspid regurgitation velocity was lower than that of fetal period, the average blood flow velocity was (246.37±11.08) cm/s, the pulmonary artery widening was improved, and the average diameter of pulmonary artery was (9.0±0.4) mm. Three months after birth, echocardiographic characteristics: right atrium, right ventricle diameter, pulmonary artery pressure were normal; 16 cases had no tricuspid regurgitation, 6 cases had mild tricuspid regurgitation.【Conclusion】Echocardiography is of high value in prenatal diagnosis of fetal ductus arteriosus early closure and stenosis. It is helpful for clinicians to evaluate the condition and provide basis for clinical delivery time.
徐光莲. 超声心动图对孕中晚期胎儿动脉导管早闭及狭窄的诊断价值[J]. 医学临床研究, 2019, 36(6): 1059-1062.
XU Guang-lian. Diagnostic value of Echocardiography in Early Closure and Stenosis of Fetal Ductus Arteriosus in the middle and Late Pregnancy. JOURNAL OF CLINICAL RESEARCH, 2019, 36(6): 1059-1062.
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