The use of fetal echocardiography in the prenatal diagnosis of aortopulmonary septal defect

doi:10.3877/cma.j.issn.1672-6448.2018.12.008

Abstract

Abstract:

Objective

To investigate the echocardiographic features and clinical significance of prenatal diagnosis of aortopulmonary septal defect (APSD).

Methods

Images of 4 cases of APSD diagnosed by fetal echocardiography during January 2008 to December 2017 in the affiliated Suzhou hospital of Nanjing medical university were reviewed. Echocardiographic features and clinical significance of prenatal diagnosis of APSD were summarized.

Results

The key feature of prenatal diagnosis of APSD was the demonstration of a connection between the ascending aorta and main pulmonary artery. The defect could be best identified on the three-vessel view, three-vessel and trachea view and short axis view of great arteries. Flow across the defect could be bidirectional, left-to-right or right-to-left. Dilated ascending aorta may be seen as an indirect sign of APSD. All the 4 cases were associated with other cardiac anomalies, including 1 case of Berry syndrome. One case was associated with extracardiac abnormalities.

Conclusions

There are fetal echocardiographic features of APSD. Berry syndrome, which was commonly associated with genetic anomaly, should be suspected when distal type APSD was found. Prenatal diagnosis of APSD is feasible and essential as a surgical correction early after birth can improve the prognosis.

Key words: Ultrasonography, prenatal, Aortopulmonary septal defect, Congenital heart disease

Qi Pan, Xuedong Deng, Zhenqi Wang, Qiuqin Xu, Jianfang Ma, Jun Zhang. The use of fetal echocardiography in the prenatal diagnosis of aortopulmonary septal defect[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(12): 925-930.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.12.008

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I12/925

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References 34

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胎儿孕周	主要心内畸形	主要诊断切面	分流方向	心外畸形或其他畸形	遗传学检查	随访结果
21^＋4	Ⅱ型主-肺动脉间隔缺损（3.8 mm），右位主动脉弓，右位动脉导管，左上腔静脉	三血管观，三血管气管观	左向右分流	单脐动脉，股骨、肱骨偏短	NA	外院引产，未尸检
22^＋3	Berry综合征：Ⅱ型主-肺动脉间隔缺损（4.7 mm)，主动脉弓离断（B型），右肺动脉发自主动脉；升主动脉增宽	三血管观，三血管气管观	左向右分流	无	NA	外院引产，未尸检
24^＋4	Ⅱ型主-肺动脉间隔缺损（3.9 mm），主动脉弓离断	三血管观，三血管气管观	左向右分流	无	46, XX，22q11del NA	出生后手术证实，存活
25	Ⅱ型主-肺动脉间隔缺损（4.3 mm），左上腔静脉，升主动脉增宽	三血管观，大动脉短轴	右向左分流	无	46, XY，22q11del NA	出生后手术证实，存活

胎儿孕周	主要心内畸形	主要诊断切面	分流方向	心外畸形或其他畸形	遗传学检查	随访结果
21^＋4	Ⅱ型主-肺动脉间隔缺损（3.8 mm），右位主动脉弓，右位动脉导管，左上腔静脉	三血管观，三血管气管观	左向右分流	单脐动脉，股骨、肱骨偏短	NA	外院引产，未尸检
22^＋3	Berry综合征：Ⅱ型主-肺动脉间隔缺损（4.7 mm)，主动脉弓离断（B型），右肺动脉发自主动脉；升主动脉增宽	三血管观，三血管气管观	左向右分流	无	NA	外院引产，未尸检
24^＋4	Ⅱ型主-肺动脉间隔缺损（3.9 mm），主动脉弓离断	三血管观，三血管气管观	左向右分流	无	46, XX，22q11del NA	出生后手术证实，存活
25	Ⅱ型主-肺动脉间隔缺损（4.3 mm），左上腔静脉，升主动脉增宽	三血管观，大动脉短轴	右向左分流	无	46, XY，22q11del NA	出生后手术证实，存活

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