产前超声诊断静脉导管缺失及走行异常

目的 探讨胎儿静脉导管(DV)缺失及走行异常的产前超声图像特征及其临床意义。方法 回顾性分析本院诊断为胎儿DV缺失及走行异常9胎的临床及声像图特征。结果 7胎DV缺失,脐静脉直接回流至右心房伴静脉导管缺失;2胎DV走行异常,1胎汇入冠状静脉窦,1胎汇入肝静脉。胎儿结局:5胎因合并畸形引产,1胎生后由于膈疝缺口太大及肺发育不良死亡,1胎28周早产死亡,2胎生后暂未见明显异常;8胎合并其他畸形,1胎孤立性DV走行异常;7胎合并心内畸形,3胎合并心外畸形。结论 产前超声检查可诊断DV缺失及走行异常;应结合畸形严重程度及染色体检查结果评价预后。

Prenatal diagnostic ultrasound of absence and aberrant drainage of ductus venosus

Objective To discuss the prenatal ultasonography and clinical significance of absence and aberrant drainage of ductus venosus (DV). Methods Nine fetuses of absence and aberrant drainage of DV were diagnosed by ultrasound. The characteristic of prenatal ultasonography were reviewd. Results Seven fetuses were umbilical vein directly to the right atrium with absence of DV; two fetuses were aberrant drainage, one fetus was DV directly drainage to the coronary sinus, one fetuses was DV drainage to the hepatic vein. Five fetuses with combined malformations underwent induced labour, one fetus was dead after preterm birth, one fetus was dead because of diaphragmatic hernia and pulmonary hypoplasia, two fetuses were favorable prognosis. Eight fetuses were combined with other abnormalities, one fetus was isolated aberrant drainage of DV; seven fetuses were combined with intracardiac abnormalities, and three fetuses were combined with extracardiac abnormalities. Conclusion Absence and aberrant drainage of DV can be diagnosed by the characteristic ultasonography. Prognosis should be evaluated according to the severity of malformations and the karyotyping of chromosome.