Diagnostic value of echocardiography for fetal ductus arteriosus constriction/closure

doi:10.3877/cma.j.issn.1672-6448.2019.07.006

Abstract

Abstract:

Objective

To assess the diagnostic value of echocardiography for fetal ductus arteriosus constriction/closure.

Methods

The data of echocardiography and clinical outcome of 9 fetuses (2 with ductus arteriosus closure and 7 with ductus arteriosus constriction) identified from 864 cases at the First Central Hospital of Baoding between January 2016 and February 2018 were reviewed retrospectively.

Results

Fetal ductus arteriosus constriction/closure mainly manifested as dilation of the right heart, enlargement of the diameter of the main pulmonary artery, increase or disappearance of the systolic and diastolic blood flow of the ductus, and increased three tricuspid regurgitation. Among the 9 cases of fetal ductus arteriosus constriction/closure, 1 died of respiratory failure 5 hours after birth, and the remaining 8 had successful live birth and underwent echocardiography one week after birth. Among the 8 cases, 3 were normal while the other 5 were significantly improved.

Conclusions

Prenatal echocardiography can effectively diagnose fetal ductus arteriosus constriction/closure. When the fetus is dysfunctional in the right ventricular system and basically mature in other physiological systems, pre-term delivery is of great clinical value in improving the quality of delivery and prognosis.

Key words: Echocardiography, Fetal, Ductus arteriosus constriction

Yuanyuan Wang, Ying Liu, Fengqun Dong, Xiaohua Zhang, Kun Wang, Qiang Li, Xiangling Wu. Diagnostic value of echocardiography for fetal ductus arteriosus constriction/closure[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(07): 521-525.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2019.07.006

https://chaosheng.cma-cmc.com.cn/EN/Y2019/V16/I07/521

Figures/Tables 4

References 17

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孕周（周）	动脉导管			肺动脉瓣口		三尖瓣口
孕周（周）	内径（mm）	收缩期峰值流速（m/s）	舒张期峰值流速（m/s）	内径（mm）	前向血流速度（m/s）	反流速度（m/s）
31^a	2.13	2.45	0.92	7.02	1.15	3.38
32^a	2.35	2.73	1.08	7.85	1.08	3.52
28^a	2.14	2.58	0.96	7.44	0.96	3.97
29^a	2.08	2.68	1.06	6.78	0.98	3.58
30^a	2.17	2.74	0.99	7.29	1.17	3.96
34^a	2.12	2.96	1.10	8.05	0.84	4.28
32^a	2.14	3.11	1.22	8.37	0.96	4.56
35^b	完全闭塞	-	-	10.00	几乎没有	5.30
36^b	完全闭塞	-	-	10.02	几乎没有	5.87

孕周（周）	动脉导管			肺动脉瓣口		三尖瓣口
孕周（周）	内径（mm）	收缩期峰值流速（m/s）	舒张期峰值流速（m/s）	内径（mm）	前向血流速度（m/s）	反流速度（m/s）
31^a	2.13	2.45	0.92	7.02	1.15	3.38
32^a	2.35	2.73	1.08	7.85	1.08	3.52
28^a	2.14	2.58	0.96	7.44	0.96	3.97
29^a	2.08	2.68	1.06	6.78	0.98	3.58
30^a	2.17	2.74	0.99	7.29	1.17	3.96
34^a	2.12	2.96	1.10	8.05	0.84	4.28
32^a	2.14	3.11	1.22	8.37	0.96	4.56
35^b	完全闭塞	-	-	10.00	几乎没有	5.30
36^b	完全闭塞	-	-	10.02	几乎没有	5.87

胎儿孕周（周）	产前超声检查				出生孕周（周）	体质量（g）	吸氧	出生后1周超声特点
胎儿孕周（周）	四腔心	主肺动脉	三尖瓣反流	动脉导管	出生孕周（周）	体质量（g）	吸氧	出生后1周超声特点
31	右心房、右心室扩大，右心室壁增厚	内径增宽，肺动脉瓣少量反流	中量反流	内径变细，收缩期及舒张期血流加速	36	3500	是	正常
32	右心房、右心室扩大，右心室壁增厚	内径增宽，肺动脉瓣中量反流	中大量反流	内径变细，收缩期及舒张期血流加速	3760	3300	否	三尖瓣极少量反流，右心稍大
28	右心房、右心室扩大	内径增宽，肺动脉瓣少量反流	中量反流	内径变细，收缩期及舒张期血流加速	37	3100	是	正常
29^a	右心明显增大	内径增宽，肺动脉瓣大量反流，胸腔和心包大量积液	大量反流	内径变细，收缩期及舒张期血流加速	35	2400	是	于出生后5 h死亡
30	右心房、右心室扩大	内径增宽，肺动脉瓣少量反流	中量反流	内径变细，收缩期及舒张期血流加速	37	3200	是	三尖瓣少量反流
34	右心房、右心室扩大	内径增宽，肺动脉瓣少量反流	大量反流	内径变细，收缩期及舒张期血流加速	36	3100	是	动脉导管可见细束分流
32	右心房、右心室扩大	内径增宽，肺动脉瓣少量反流	中量反流	内径变细，舒张期及收缩期血流加速	37	3300	否	正常
36	右心房、右心室明显扩大，右心室壁运动明显减弱	内径增宽，启闭幅度明显减弱，几乎没有前向血流信号	少量反流	血流信号中断	36	3300	是	右心稍大，三尖瓣少量反流，心功能正常
37	右心房、右心室扩大，右心室壁运动明显减弱，卵圆孔右向左分流量明显增加，少量心包积液	内径增宽，动脉导管前无血流信号	少量反流	血流信号中断	37	3100	是	心脏形态及功能正常，三尖瓣少量反流

胎儿孕周（周）	产前超声检查				出生孕周（周）	体质量（g）	吸氧	出生后1周超声特点
胎儿孕周（周）	四腔心	主肺动脉	三尖瓣反流	动脉导管	出生孕周（周）	体质量（g）	吸氧	出生后1周超声特点
31	右心房、右心室扩大，右心室壁增厚	内径增宽，肺动脉瓣少量反流	中量反流	内径变细，收缩期及舒张期血流加速	36	3500	是	正常
32	右心房、右心室扩大，右心室壁增厚	内径增宽，肺动脉瓣中量反流	中大量反流	内径变细，收缩期及舒张期血流加速	3760	3300	否	三尖瓣极少量反流，右心稍大
28	右心房、右心室扩大	内径增宽，肺动脉瓣少量反流	中量反流	内径变细，收缩期及舒张期血流加速	37	3100	是	正常
29^a	右心明显增大	内径增宽，肺动脉瓣大量反流，胸腔和心包大量积液	大量反流	内径变细，收缩期及舒张期血流加速	35	2400	是	于出生后5 h死亡
30	右心房、右心室扩大	内径增宽，肺动脉瓣少量反流	中量反流	内径变细，收缩期及舒张期血流加速	37	3200	是	三尖瓣少量反流
34	右心房、右心室扩大	内径增宽，肺动脉瓣少量反流	大量反流	内径变细，收缩期及舒张期血流加速	36	3100	是	动脉导管可见细束分流
32	右心房、右心室扩大	内径增宽，肺动脉瓣少量反流	中量反流	内径变细，舒张期及收缩期血流加速	37	3300	否	正常
36	右心房、右心室明显扩大，右心室壁运动明显减弱	内径增宽，启闭幅度明显减弱，几乎没有前向血流信号	少量反流	血流信号中断	36	3300	是	右心稍大，三尖瓣少量反流，心功能正常
37	右心房、右心室扩大，右心室壁运动明显减弱，卵圆孔右向左分流量明显增加，少量心包积液	内径增宽，动脉导管前无血流信号	少量反流	血流信号中断	37	3100	是	心脏形态及功能正常，三尖瓣少量反流

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