产前超声诊断胎儿右房异构一例

本文报道产前超声诊断胎儿右房异构一例。孕妇孕24周产前超声检查发现胎儿左位心合并复杂心血管畸形(右心室双出口、房室间隔缺损、肺动脉发育不良、双侧上腔静脉、心下型完全型肺静脉异位引流)、胃泡位于腹腔右侧、中位肝、可疑无脾、腹主动脉与下腔静脉位于脊柱左侧、双侧支气管呈右侧支气管对称形态,综合考虑右房异构可能。引产后经尸体解剖证实脾脏发育不良、右房异构。右房异构常合并复杂心血管畸形,因此产前超声发现复杂心血管畸形时,应警惕右房异构的可能。右房异构病死率极高,产前诊断具有重要意义。

Fetal right atrial isomerism diagnosed on prenatal ultrasound:a case report

We reported a case of fetus with right atrial isomerism diagnosed by ultrasound prenatally.Right atrial isomerism was suspected based on several kinds of abnormalities detected at 24 gestational weeks by ultrasound imaging,such as levocardia complicated by complex cardiovascular malformations(double outlet of right ventricle,atrioventricular septal defect,pulmonary artery dysplasia,bilateral superior vena cava and infracardiac total anomalous pulmonary venous drainage),abnormal right-sided stomach bubble,midline liver,suspicious absence of the spleen,juxtaposition of the abdominal aorta and the inferior vena cava to the left side,and mirror-image right bronchia.Autopsy confirmed all of the prenatal diagnosis with an additional finding of splenic dysplasia.Right atrial isomerism should be considered when ultrasound findings indicate complex cardiovascular malformations.Given the high mortality rate of right atrium isomerism,prenatal diagnosis is of great importance.