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1.
胰腺异常属罕见先天性畸形,环状胰腺胎儿常伴发多种畸形,病死率高且预后差,产前超声早期诊断对降低围生期死亡率具有重要意义。由于胎儿胰腺位置隐蔽且体积小,在产前超声检查中常易被忽视。近年来,随着产前超声检查技术不断进步及产科检查需求更加全面、细致,利用产前超声观察胎儿胰腺大小、形态及回声越来越受到关注。本文主要对胰腺的胚胎发育、胎儿胰腺的解剖学基础及超声检查研究等进展进行综述。  相似文献   

2.
尿道下裂是胎儿常见泌尿系统先天畸形。产前二维及三维超声检查均可用于诊断胎儿尿道下裂,二者联合可提高诊断效能;在此基础上进行彩色多普勒超声检查可进一步明确尿道开口位置,提高诊断准确率,降低误诊率。本文对产前超声诊断胎儿尿道下裂进展进行综述。  相似文献   

3.
主动脉弓离断是一种罕见的严重先天性心脏病,胎儿期死亡率极高,其胚胎学起源复杂,表现形式多样,且多合并其他畸形,产前超声诊断困难。超声心动图作为目前临床常用的胎儿心脏检查手段,在先天性心脏病的筛查中发挥重要作用。本文主要从二维超声、三维超声在诊断中的应用及超声鉴别诊断方面对胎儿主动脉弓离断的产前超声诊断现状进行综述。  相似文献   

4.
胎儿产前超声检查对胎位和诊断医师的技术水平依赖性较强,尤其当胎儿存在复杂的心脏和颅脑结构异常时,超声检查难度更大。智能三维超声可对容积数据进行"自动"分析和测量,简化操作流程,获得诊断所必须的标准切面,减少对操作医师技术的依赖性,提高对疾病的诊断准确率。本文对智能三维超声成像技术在胎儿心脏切面、颅脑正中矢状面、颈项透明层切面的自动获取及参数自动测量等方面的应用特点和新进展进行综述。  相似文献   

5.
目的 探讨产前超声检查对胎儿畸形的临床意义.方法 2007年9月~2010年9月在笔者所在医院产前胎儿畸形超声筛查31298例.结果 31298例孕妇中产前超声筛查及产后证实胎儿畸形213例胎儿畸形,神经系统畸形最为多见.结论 开展前超声筛查尤为重要,如检测出异常,及时终止妊娠,把畸形胎儿的发生率降到最低点,以达到优生目的.  相似文献   

6.
目的:探讨超声检查在产前筛查胎儿畸形中的临床应用价值.方法:回顾性分析我院2009年1月~2011年1月妇产科常规超声检查6226例,其中检出胎儿畸形181例,漏诊3例.结果:通过常规超声检查,胎儿畸形检出率为2.9%(181/6226),多数经引产,手术或追踪随访证实.结论:产前超声检查能及早确定胎儿有无发育畸形,且诊断率高,无创,操作简便,重复操作性强,具有十分重要的临床诊断价值.  相似文献   

7.
目的探讨胎儿主动脉弓离断的超声诊断特点。方法回顾性分析产前超声诊断为胎儿主动脉弓离断的35胎胎儿资料,同时纳入180胎正常胎儿。二维超声判断胎儿内脏及心脏位置,获取四腔心切面、左右心室流出道切面、三血管切面及三血管-气管切面等横断面,并扫查腔静脉长轴切面、主动脉弓切面及动脉导管弓切面等矢状切面。测量主动脉弓离断胎儿左右心室内径比值及主动脉与肺动脉内径比值,并与相应孕周的正常胎儿进行比较。结果产前二维超声诊断A型、B型及C型主动脉弓离断分别为16、18及1胎,均伴室间隔缺损,共27胎经尸体检查或产后检查证实产前诊断,3胎诊断错误,余5例新生儿失访。四腔心切面及三血管切面发现主动脉弓离断胎儿左右心室内径比值和主动脉与肺动脉内径比值显著小于相应孕周正常胎儿,差异有统计学意义(P均0.01)。矢状切面对主动脉追踪连续扫查可确定主动脉的分支及走行,可明确诊断及分型。A型、B型及C型离断升主动脉走行及分支分别呈现典型的"W型"、"Y型"及"I型"。矢状面扫查及横断面扫查对胎儿主动脉弓离断的诊断率分别为90.00%(27/30)及56.67%(17/30),差异有统计学意义(P0.01)。结论产前二维超声可诊断胎儿主动脉弓离断,横断面扫查可发现某些线索,矢状面连续扫查对诊断胎儿主动脉弓离断具有重要意义。  相似文献   

8.
目的研究产前超声畸形筛查及产后超声随访在非产前诊断医院中的应用。方法回顾性分析笔者所在医院2008~2011年诊断为胎儿畸形的资料,对比2006~2008年检出畸形胎儿的资料,对检出的数量及结构进行比较。结果阻止畸形胎儿出生数,检出畸形的种类均明显高于开展产前系统超声检查前,开展产后超声随访有效的避免医疗纠纷的发生。结论在非产前诊断医院,特别是县市级医院合理开展系统超声胎儿畸形筛查能对优生优育起到很大的促进作用。  相似文献   

9.
产前超声提示透明隔腔增宽胎儿结局分析   总被引:2,自引:1,他引:1  
目的分析产前超声提示胎儿透明隔腔(CSP)增宽胎儿结局,探讨其临床意义。方法对产前超声检查提示CSP增宽胎儿进行随访,记录产前检查结果及围生儿结局。结果超声提示CSP增宽胎儿48胎,失访9胎,最终39胎纳入研究,其中孤立性CSP增宽13胎,合并其他超声提示异常26胎。对11胎行染色体检查,其中2胎异常。6胎因各种畸形接受引产;1胎孕38周不明原因胎死宫内;2胎产后数天内死亡;1胎出生后运动、认知发育迟缓;29胎(包括13胎孤立性CSP增宽及16胎CSP增宽合并其他轻微异常)出生后(3~46个月)与同龄儿比较未见明显异常。结论产前超声提示孤立性CSP增宽胎儿结局良好;合并其他畸形时,预后取决于伴发畸形的严重程度。  相似文献   

10.
目的 分析不同类型泌尿系统畸形胎儿的彩色多普勒超声声像图的特征,评价彩色多普勒超声对高龄孕妇在产前诊断泌尿系统畸形胎儿的临床研究和诊断价值.方法 随机选择2014年3月至2016年2月本院接收的1 642例平均年龄为35.2岁且孕周为14~38周的孕妇,进行彩色多普勒常规检查,同时观测孕妇腹中胎儿的健康状况,收集对孕妇以及胎儿的临床资料和彩色多普勒超声声像特征并进行统计分析,并对怀疑为泌尿系统畸形的胎儿进行随访验证.对检测出泌尿系统畸形胎儿、疑似泌尿系统畸形胎儿和漏诊的病例,在分娩后进行彩色多普勒超声诊断和随访,将随访的结果与产前彩色多普勒超声检查的统计结果相对照.结果 通过彩色多普勒超声检测1 642例孕妇,对其超声声像特征的资料进行分析,根据超声声像图特征做出诊断.检测发现有42例泌尿系统畸形的胎儿,包含肾发育不良胎儿4例,占9.5%;多囊性发育不良8例,占19.04%;肾盂扩张15例,占35.7%;肾积水6例,占14.3%;肾缺如7例,占16.7%;巨膀胱1例,占2.4%;尿道下裂1例,占2.4%;进行产前彩色多普勒超声检测的诊断结果与分娩后检查和随访结果一致,其中一例被误诊,产妇分娩后病症消失.结论 产前对高龄孕妇进行彩色多普勒超声检查,诊断出泌尿系统畸形胎儿的准确率较高.利用彩色多普勒超声检测,使得泌尿系统畸形胎儿在产前即可作出诊断,为临床诊断、采取措施和预后评估提供了可靠且重要的依据.  相似文献   

11.
Congenital heart disease is the most common fetal congenital malformations; however, the prenatal rate detection still is low. The two-dimensional echocardiography is the "gold standard" exam to screening and diagnosis of congenital heart disease during the prenatal; however, this exam is operator-depending and it is realized only in high risk pregnancies. Spatio-temporal image correlation is a three-dimensional ultrasound software that analyses the fetal heart and your connections in the multiplanar and rendering modes; however, spatio-temporal image correlation too is operator-depending and time-consuming. We presenting a new three-dimensional software named Sonocubic fine to the screening of congenital heart disease. This software applies intelligent navigation technology to spatio-temporal image correlation volume datasets to automatically generate nine fetal echocardiography standard views. Thus, this new software tends to be less operator-depending and time-consuming.  相似文献   

12.
Fetal heart movement and fetal heart rate are easily observed with real-time ultrasonography. Certain aspects of fetal cardiac disorders can thus be further evaluated by M-mode echocardiography. Congenital heart block and associated connective tissue disorders are discussed.  相似文献   

13.
Continuous fetal hemodynamic monitoring during in-utero surgery is desirable, but it is often not feasible without intermittent interruption. We report the use of a fetal spiral electrode for continuous heart rate monitoring during fetal myelomeningocele repair. Fetal echocardiography and a fetal spiral electrode were used to monitor fetal heart rate during in-utero repair at 25 weeks’ gestation. We observed good agreement between echocardiographic and spiral electrode heart rate measurements. Using the Bland-Altman approach, the mean (SD) difference between measurements was 1.8 (3.5) beats per minute with limits of agreement of −5.3 to 8.8 beats per minute. This case illuminates a potential role for a fetal spiral electrode as a real-time adjunct in fetal interventions.  相似文献   

14.
Maternal cardiac dysfunction is associated with pre-eclampsia, fetal growth restriction and haemodynamic instability during obstetric anaesthesia. There is growing interest in the use of non-invasive cardiac output monitoring to guide antihypertensive and fluid therapies in obstetrics. The aim of this study was to validate thoracic bioreactance using the NICOM® instrument against transthoracic echocardiography in pregnant women, and to assess the effects of maternal characteristics on the absolute difference of stroke volume, cardiac output and heart rate. We performed a prospective study involving women with singleton pregnancies in each trimester. We recruited 56 women who were between 11 and 14 weeks gestation, 57 between 20 and 23 weeks, and 53 between 35 and 37 weeks. Cardiac output was assessed repeatedly and simultaneously over 5 min in the left lateral position with NICOM and echocardiography. The performance of NICOM was assessed by calculating bias, 95% limits of agreement and mean percentage difference relative to echocardiography. Multivariate regression analysis evaluated the effect of maternal characteristics on the absolute difference between echocardiography and NICOM. The mean percentage difference of cardiac output measurements between the two methods was ±17%, with mean bias of −0.13 l.min−1 and limits of agreement of −1.1 to 0.84; stroke volume measurements had a mean percentage difference of ±15%, with a mean bias of −0.8 ml (−10.9 to 12.6); and heart rate measurements had a mean percentage difference of ±6%, with a mean bias of −2.4 beats.min−1 (−6.9 to 2.0). Similar results were found when the analyses were confined to each individual trimester. The absolute difference between NICOM and echocardiography was not affected by maternal age, weight, height, race, systolic or diastolic blood pressure. In conclusion, NICOM demonstrated good agreement with echocardiography, and can be used in pregnancy for the measurement of cardiac function.  相似文献   

15.
BACKGROUND: Postoperative echocardiography windows are often of poor quality because of intervening air spaces around the heart and great vessels. We assessed the utility of a new commercially available adult chest drainage tube that has been modified with the addition of a sterile sleeve to accommodate the introduction of a nonsterile pediatric transesophageal echocardiography (TEE) probe. The TEE probe lies in a substernal epicardial position on the postoperative heart allowing one to perform substernal epicardial echocardiography (SEE). METHODS: Informed consent was obtained from 21 consecutive adult cardiac operation patients. At the completion of the operation the SEE drainage tube was inserted through the rectus muscle and into the pericardium. After chest closure, all patients underwent a full echo examination using an Acuson pediatric biplane probe in the SEE position. Views obtained and ease of insertion were judged on a 1 to 10 (worst to best) scale. RESULTS: Full SEE examinations were completed in an average of 12 minutes. Ease of probe entry and manipulation was excellent (ratings of 9.3 and 9.6, respectively). The quality of the anatomic images was also excellent. Substernal epicardial echocardiography tube positioning was integral to the orientation of the images obtained. There were no complications related to the placement of the SEE tubes or TEE probes. In 4 of 21 patients (19%) the SEE methodology was used serially in the intensive care unit to accurately assess ventricular function and filling during weaning of an intraaortic balloon and inotropic agents. CONCLUSIONS: Substernal epicardial echocardiography is a safe and highly effective methodology for the serial echocardiographic assessment of the postoperative heart.  相似文献   

16.
We have studied the effects of an extradural block using bupivacainewith adrenaline 90–100 µg on blood flow in the maternaluterine and placental arcuate arteries and the fetal umbilical,renal and middle cerebral arteries, using a colour Doppler techniquein eight healthy parturients undergoing elective Caesarean section.Fetal myocardial function was investigated simultaneously byM-mode echocardiography. Maternal heart rate increased and diastolicarterial pressure decreased after extradural administrationof bupivacaine with adrenaline. The latter effect was relievedby increasing the infusion rate in every case and none of thepatients required vaso-pressors. There were no significant differencesin maternal or fetal blood velocity waveforms, and no significantchanges were found in any of the fetal myocardial measurementsrelative to control values. These observations suggest thatextradural anaesthesia using bupivacaine with adrenaline doesnot have an adverse effect on vascular resistance in the uteroplacentalor fetal circulations or on fetal myocardial function in normalpregnancy when bupivacaine-adrenaline is administered fractionallyand maternal hypotension is prevented by rapid crystalloid volumeloading.  相似文献   

17.
AIMS: Cryopreserved mitral allograft valve (MAV) offers theoretical advantages over conventional mechanical or biological prostheses in tricuspid position, especially in infectious endocarditis patients. MAV processing and tricuspid valve (TV) replacement in a sheep model is described. METHODS AND RESULTS: In 20 adult sheep, MAV were harvested, processed and cryopreserved. One month later, recipient's TV were excised and the MAVs were transplanted into the tricuspid position in 13 sheep, under general anaesthesia, via a right thoracotomy, with an extracorporeal circulation (ECC) and cardioplegic heart arrest. Both MAV papillary muscles were anchored into the right ventricular wall by transmural stitches and the MAV anulus was sewn into the recipient's tricuspid anulus. After weaning from ECC, the anatomy and function of the MAV in the tricuspid position was assessed by epicardial echocardiography. The average duration of the ECC was 58 minutes (42-88), the cardioplegic heart arrest was 36 minutes (28-45). Weaning from EEC was always uneventful. Right atrial & pulmonary artery pressure measurements and epicardial echocardiography documented good function of all MAVs. CONCLUSION: MAV remained mechanically strong enough for implantation into the tricuspid position. Reproducible technique of MAV transplantation into the tricuspid position with excellent early postoperative haemodynamic performance was developed.  相似文献   

18.
BACKGROUND AND OBJECTIVE: Transoesophageal echocardiography is increasingly used for evaluation and monitoring of left ventricular function in anaesthetized patients. However, the only available reference values for transoesophageal echocardiography were derived from studies in awake subjects. METHODS: We determined left ventricular dimensions and systolic function in 45 patients without clinical evidence of heart disease who voluntarily underwent transesophageal echocardiography under conditions of balanced general anaesthesia, controlled fluid administration, supine position, muscle relaxation and controlled ventilation. RESULTS: The left ventricular dimensions obtained during these conditions were lower than the published normal values in awake subjects. The indices of global left ventricular function, however, were similar to the normal values obtained by either awake transesophageal echocardiography or transthoracic echocardiography. CONCLUSION: We propose using the values obtained in our study as reference values for evaluation of left ventricular function in patients under general anaesthesia and controlled ventilation.  相似文献   

19.
The effects of two vasopressors, ephedrine and etilefrine, on blood flow in maternal uterine, fetal umbilical, middle cerebral and renal arteries and on fetal myocardial function were studied by colour Doppler and M-mode echocardiography techniques during spinal anaesthesia for caesarean section. There were 7 healthy pregnant women in each treatment group. The vascular resistance of maternal uterine arteries increased significantly after both of the vasopressors while the vascular resistance of the umbilical artery remained unchanged. Ephedrine decreased the blood velocity waveform indices in the fetal middle cerebral and renal arteries, increased fetal right ventricular contractility and decreased left ventricular inner end-diastolic dimension. Fetal heart rate was unchanged. Etilefrine caused no detectable changes in fetal haemodynamics or in fetal myocardial function. These findings demonstrate that vasopressors administered for the treatment of minor maternal arterial pressure fall produce vasoconstriction in the uterine circulation during spinal anaesthesia, yet healthy fetuses seem to tolerate these haemodynamic alterations well. On the other hand, ephedrine caused changes in fetal myocardial function and in the vascular resistance of fetal middle cerebral and renal arteries, which demonstrates the potential modifying effect of vasoactive drug given to the mother on fetal haemodynamics.  相似文献   

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