经腹部彩色多普勒超声对孕早期胎儿心律失常的初步研究

目的：探讨经腹部彩色多普勒超声诊断孕早期胎儿心律失常可行性及临床价值。材料和方法：采用经腹部彩色多普勒超声对11956例孕12~14周胎儿进行检查,应用M型和多普勒超声等多种方法诊断胎儿心律失常并分析其类型。观察是否存在胎儿心脏结构及其他异常,对存活病例均于孕22-24周行系统的胎儿超声心动图检查,超声结果与胎儿引产结果及出生后彩色多普勒超声对照。结果：11956例中发现胎儿心律失常12例(12/11956,0.1%)。其中窦性心动过速9例；心动过缓2例(房室传导阻滞)；房性早搏1例。合并胎儿畸形6例,包括胎儿先天性心脏病4例,肢体-体壁综合征1例;胎儿水肿1例,均中止妊娠,结果与产前诊断相符。结论：经腹部彩色多普勒超声能早期诊断胎儿心律失常及胎儿系统畸形,对临床早期干预和处理有重要的指导意义。

Study of TransabdominalColor Doppler Ultrasound in Diagnosis ofFetal Arrhythmia during First-trimester

Purpose To evaluate transabdominal color doppler ultrasound in diagnosing fetal arrhythmia in the first trimester. Materials and MethodsTotal 11956 women with common pregnancy were submitted to diagnosed whether they were fetal arrhythmiawith transabdominal color doppler ultrasound during 12-14 gestation. Analyze the types of arrhythmia with combination of color doppler and M-mode of ultrasonic methods and observe whether they were with complicated structural abnormality. The results of transabdominal color doppler ultrasound were comparedwith autopsy after induced labor or echocardiogram after born. Results 12 cases with fetal arrhythmia were diagnosed by transabdominalultrasound(0.1%,12/11956), of which 9cases were sinus tachycardia, 2 cases were bradycardia(atrioventricular heart -block),1 case were atrial extrasystole. Half of the fetal arrhythmia cases were combined with fetal abnormalities, including 4 cases of congenital heart diseases,1 case of limb body wall complex, 1 case of hydrops fetal. Allof the 6 cases were termination of pregnancy. Follow-up results were consistent withSprenatal diagnosis. Conclusion Transabdominal color doppler ultrasound can contribute to early detection of fetal arrhythmia and structural abnormalities,and provide important reference for early clinical intervene and manage.