胎儿永存左上腔静脉提示胎儿心内外畸形的产前诊断意义

目的：探讨永存左上腔静脉提示胎儿伴发心内、外畸形的产前诊断意义。方法回顾性分析了2013年至2015年来保定市第一中心医院东院彩超室经胎儿超声心动图检查确诊为永存左上腔静脉的胎儿32例，对其合并心内、外畸形的种类进行分析，并随访了病理解剖和分娩后情况。结果32例永存左上腔静脉胎儿中，18例是单纯的永存左上腔静脉，14例（占43．75％）合并心内或心外异常，其中5例表现为单纯的心内结构畸形，9例合并严重的胎儿心内、外畸形。心内结构畸形主要有右室双出口、法洛氏四联症、室间隔缺损、肺动脉狭窄、主动脉弓缩窄、部分型肺静脉异位引流、 I孔型房缺、永存左上腔静脉伴右上腔静脉缺如、部分型心内膜垫缺损、心肌病。心外结构异常主要有唇腭裂、内脏反位、肾多囊性发育不良、肾缺如、肾积水、草莓头、后颅窝池宽、脉络丛囊肿、折叠指、摇椅足、足内翻、单脐动脉、腹腔积液、脐血频谱异常等。结论永存左上腔静脉与胎儿心内、外畸形密切相关，其可以作为一项重要的标志指导产前诊断。

Value of ultrasound detection of persistent left superior vena cava in screening fetal cardiac and extracar-diac anomaly

Objective To investigate the relationship between the persistent left superior vena cava ( PLSVC ) and fetal anomaly ,and the significance of prenatal diagnosis .Methods 32 cases of fetuses with PLSVC who were diagnosed by fetal echocardiography were analyzed retrospectively .We made a classification study on the malfor-mation,followed the pathological anatomy and the situation after the delivery .Results The results indicated that 18 cases had isolate PLSCV , 14 cases ( 43 .75%) had cardiac and extracardiac anomaly .In these deformed fetuses,5 cases had isolate heart defects ,9 cases had severe fetal anomaly .Heart defect included double outlet right ventricle , tetralogy of Fallot ,ventricular septal defect ,pulmonary stenosis ,coarctation if the aotaabsent ,partial anomalous venous connection ,primum atrial septal defect ,right superior vena cava with persistent left superior vena cava,extracardiac anomaly included cleft lip and palate ,situs inversus viscerum ,multicystic dysplastic kidney , unilateral kidney,uronephrosis,strawberry head,posterior cranial fossa widened ,choroid plexus cysts,fold finger, rockcr-bottom foot,foot varus,single umbilical artery,pyoperitoneum,abnormal blood flow spectrum.Conclusion PLSVC detected in fetuses is frequently associated with cardiac and extracadiac anomaly .It can be used as effec-tive clinical significance in fetal screening .